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Scan Finds Risk Signs Long Before Alzheimer’s

August 26, 2011
Written by: , Filed in: Neuroradiology
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Advanced imaging has detected biochemical changes in the brains of cognitively normal people that may indicate risk of Alzheimer’s disease, according to a study published Wednesday in the online issue of Neurology.

Jonathan M. Schott, MD, of the Dementia Research Centre at the University College London Institute of Neurology in England said the study results pointed to the potential benefits of scanning as a screening tool:

If we could identify people in whom the disease process has started but symptoms have not yet developed, we would have a potential window of opportunity for new treatments—as and when they become available—to prevent or delay the start of memory loss and cognitive decline.

Dr. Schott was quoted in an American Academy of Neurology news release about the study. He also wrote an editorial in Neurology commenting on the study.

The study examined 311 people in their 70s and 80s who exhibited no cognitive problems. They were part of the population-based Mayo Clinic Study of Aging.

PET brain scans found that 33 percent of the participants had significantly high levels of amyloid-beta deposits, or plaques, which are one of the first signs of the brain changes that lead to Alzheimer’s.

Proton MR spectroscopy found that those with high levels of amyloid-beta deposits also tended to have high levels of the brain metabolites myoinositol/creatine and choline/creatine. Subjects with high levels of choline/creatine were more likely to have lower scores on cognitive tests, whether or not they had amyloid-beta deposits.

Obviously, we don’t yet know which, if any, of these subjects will develop Alzheimer’s. However, said study author Kejal Kantarci, MD:

This relationship between amyloid-beta deposits and these metabolic changes in the brain are evidence that some of these people may be in the earliest stages of the disease.

Dr. Kantarci is an associate professor of radiology at the Mayo Clinic in Rochester, Minnesota.

The only definitive way to diagnose Alzheimer’s, still, is an autopsy. However, if brain imaging could accurately detect presymptomatic signs of the disease, that would be immensely helpful as treatments are discovered. And it would open the possibility of a comprehensive new screening regimen along the lines of mammography.

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