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fMRI Uncovers Secrets Of Alzheimer’s Origin

December 27, 2013
Written by: , Filed in: Neuroradiology
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Where does Alzheimer’s disease start in the brain? Why does it start there? How does it spread?

Researchers at Columbia University Medical Center in New York think they know, thanks to high-resolution functional MRI. Scott A. Small, MD, co–senior author of a study about the findings, explained the implications:

Now that we’ve pinpointed where Alzheimer’s starts and shown that those changes are observable using fMRI, we may be able to detect Alzheimer’s at its earliest preclinical stage, when the disease might be more treatable and before it spreads to other brain regions.

Dr. Small is professor of radiology, Boris and Rose Katz Professor of Neurology, and director of the Alzheimer’s Disease Research Center. He was quoted in a Columbia news release. An article about the research was published online Sunday in Nature Neuroscience.

The researchers imaged the brains of 96 adults enrolled in the Washington Heights-Inwood Columbia Aging Project in New York and followed them for an average of three and a half years. All subjects were free of dementia at the time they enrolled. Twelve developed mild Alzheimer’s disease during the course of the study.

The scans showed that Alzheimer’s first affected the lateral entorhinal cortex (LEC). “The LEC is considered to be the gateway to the hippocampus, which plays a key role in the consolidation of long-term memory, among other functions,” said Dr. Small. “If the LEC is affected, other aspects of the hippocampus will also be affected.”

The disease then spreads to other areas of the cerebral cortex, particularly the parietal cortex. But it doesn’t originate until changes in both tau and amyloid precursor protein (APP) occur. “The LEC is especially vulnerable to Alzheimer’s because it normally accumulates tau, which sensitizes the LEC to the accumulation of APP,” said co–senior author Karen E. Duff, PhD. Dr. Duff is professor of pathology and cell biology at Columbia and the New York State Psychiatric Institute.

“Together, these two proteins damage neurons in the LEC, setting the stage for Alzheimer’s.”

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Incidental findings: the term may be a “zingy” way of describing something that shows up on an image other than what you were looking for, but one doctor says she won’t use it anymore. To find out why, see our Facebook page.

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