The Japanese journal of neuropsychology

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ArticleTitle	Neuroimaging in Alzheimer's disease
Language	J
AuthorList	Hiroshi Matsuda
Affiliation	Department of Nuclear Medicine, Saitama Medical University International Medical Center
Publication	Japanese Journal of Neuropsychology: 24 (3), 235-241, 2008
Received
Accepted
Abstract	Main purposes of neuroimaging in Alzheimer's disease have been moved from diagnosis of advanced Alzheimer's disease to diagnosis of very early Alzheimer's disease at a prodromal stage of mild cognitive impairment, prediction of conversion from mild cognitive impairment to Alzheimer's disease, differential diagnosis from other diseases causing dementia, and evaluation of therapeutical effects.. Structural MRI studies and functional studies using FDG-PET and brain perfusion SPECT have been widely used in diagnosis of Alzheimer's disease. Outstanding progress in diagnostic accuracy of these neuroimaging modalities has been obtained using statistical analysis on a voxel-by-voxel basis after spatial normalization of individual scans to a standardized brain-volume template instead of visual inspection or a conventional region of interest technique. In a very early stage of Alzheimer's disease, this statistical approach revealed gray matter loss in the entorhinal and hippocampal areas and hypometabolism or hypoperfusion in the posterior cingulate cortex and precuneus. These two findings might be related in view of anatomical knowledge that the regions are linked through the circuit of Papez. This statistical approach also offers accurate evaluation of therapeutical effects on brain metabolism or perfusion. The latest development in functional imaging relates to the final pathological hallmark of Alzheimer's disease- amyloid plaques. Amyloid imaging analyzed by statistical approach might be an important surrogate marker for trials of disease-modifying agents.
Keywords	SPECT, PET, MRI, Alzheimer's disease