The clinical use of structural MRI in Alzheimer disease

Abstract

Structural imaging based on magnetic resonance is an integral part of the clinical assessment of patients with suspected Alzheimer dementia. Prospective data on the natural history of change in structural markers from preclinical to overt stages of Alzheimer disease are radically changing how the disease is conceptualized, and will influence its future diagnosis and treatment. Atrophy of medial temporal structures is now considered to be a valid diagnostic marker at the mild cognitive impairment stage. Structural imaging is also included in diagnostic criteria for the most prevalent non-Alzheimer dementias, reflecting its value in differential diagnosis. In addition, rates of whole-brain and hippocampal atrophy are sensitive markers of neurodegeneration, and are increasingly used as outcome measures in trials of potentially disease-modifying therapies. Large multicenter studies are currently investigating the value of other imaging and nonimaging markers as adjuncts to clinical assessment in diagnosis and monitoring of progression. The utility of structural imaging and other markers will be increased by standardization of acquisition and analysis methods, and by development of robust algorithms for automated assessment.

High‐fat diet protects the blood–brain barrier in an Alzheimer's disease mouse model

“…Ventricular enlargement is a highly reproducible measure of Alzheimer's progression, owing to the high contrast between the CSF and the surrounding brain tissue on T1‐weighted images (Frisoni, Fox, Jack, Scheltens, & Thompson, 2010). The ventricles expand by 5%–16% per year in patients with AD and by 1.5%–3.0% per year in healthy elderly individuals.…”

Computationale Neuroanatomie und Mikrostrukturbildgebung mit der Magnetresonanztomographie

“…B. T1-gewichtete Bildgebung) bestimmt werden und beispielsweise genutzt werden, um die räumliche und zeitliche Dynamik der menschlichen Gehirnstruktur sowohl in gesunden als auch Patientengruppen zu quantifizieren [5]. Obwohl diese morphologischen Maße für die Diagnose von Krankheiten wie der AlzheimerKrankheit hohe Relevanz haben [6], sind sie nicht immer eindeutig zuordenbar und reproduzierbar, da Verän-derungen im Bildkontrast aufgrund von mikroskopischen Veränderungen [7] fälschlicherweise als Volumenänderun-gen identifiziert werden können oder durch verschiedene mikrostrukturelle Prozesse verursacht werden können.…”

Molecular Brain Imaging in the Multimodality Era

“…Structural MRI for neuroimaging applications is often T 1 -and/or T 2 -weighted ( Figures 1B and 1D, row 2) with related sequences optimized for imaging of vasculature and brain pathology (Frisoni et al, 2010;Tartaglia et al, 2011). Diffusion-weighted imaging reflects water diffusivity and diffusion tensor imaging (DTI) (e.g., apparent diffusion coefficient and fractional anisotropy) assessments of white matter integrity and axonal architecture have become more routine ( Figures 1C and 1D, rows 3 and 4).…”