Quantitative structural MRI for early detection of Alzheimer’s disease

Abstract

Alzheimer’s disease (AD) is a common progressive neurodegenerative disorder that is not currently diagnosed until a patient reaches the stage of dementia. There is a pressing need to identify AD at an earlier stage, so that treatment, when available, can begin early. Quantitative structural MRI is sensitive to the neurodegeneration that occurs in mild and preclinical AD, and is predictive of decline to dementia in individuals with mild cognitive impairment. Objective evidence of ongoing brain atrophy will be critical for risk/benefit decisions once potentially aggressive, disease-modifying treatments become available. Recent advances have paved the way for the use of quantitative structural MRI in clinical practice, and initial clinical use has been promising. However, further experience with these measures in the relatively unselected patient populations seen in clinical practice is needed to complete translation of the recent enormous advances in scientific knowledge of AD into the clinical realm.

Keywords::

• amyloid
• biomarker
• CSF
• mild cognitive impairment
• prodromal Alzheimer’s disease
• quantitative neuroimaging
• volumetric imaging

Financial & competing interests disclosure

Linda K McEvoy is supported by NIA K01AG029218; James B Brewer is supported by NINDS K02 NS067427. Linda K McEvoy’s spouse is President of CortTechs, Inc. James B Brewer is an investigator for, and receives research funds from, Janssen Alzheimer Immunotherapy; he also receives research funds from GE medical foundation and has served on an advisory board for Elan Pharmaceuticals. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.