What is the role of MRI in the diagnosis of Alzheimer disease?

Answer

MRI is able to identify structural changes, including patterns of atrophy, that characterize neurodegenerative diseases, and can distinguish these from other causes of cognitive impairment, such as infarcts, space-occupying lesions, and hydrocephalus.^[31]

Rates of whole brain and hippocampal atrophy from MRI scans can aid in disease diagnosis and tracking of pathologic progression in neurodegenerative diseases. Many studies have shown that cerebral atrophy is significantly greater in patients with Alzheimer disease than in persons without it. However, the variability of atrophy in the normal aging process makes it difficult to use MRI as a definitive diagnostic technique.^{[32, 33, 34, 23]} (See the images below.)

Coronal, T1-weighted magnetic resonance imaging (MRI) scan in a patient with moderate Alzheimer disease. Brain image reveals hippocampal atrophy, especially on the right side.

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Axial, T2-weighted magnetic resonance imaging (MRI) scan of the brain reveals atrophic changes in the temporal lobes.

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Axial, T2-weighted magnetic resonance imaging (MRI) scan shows dilated sylvian fissure resulting from adjacent cortical atrophy, especially on the right side.

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Axial, T1-weighted magnetic resonance imaging (MRI) scan shows a dilated sylvian fissure caused by adjacent cortical atrophy.

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Axial, T1-weighted magnetic resonance imaging (MRI) scan shows bilateral cortical atrophy with accentuated cortical sulci; there is decreased involvement in the posterior aspect.

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Axial, T1-weighted magnetic resonance imaging (MRI) scan shows bilateral cortical atrophy with accentuated cortical sulci; there is decreased involvement in the posterior aspect.

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Fox et al used an automated technique that is potentially applicable, in the clinical setting, to subtractiom MRI scans obtained an average of 1 year apart. They observed that there was a significant difference between the rate of change in patients with Alzheimer disease and the rate in control subjects. With MRI, sensitivity and specificity were approximately 90% for predicting the decline in dementia.^[35]

Changes in hippocampal volume, shape, symmetry and activation are reflected by cognitive impairment.^[29]Early MRI studies to evaluate the size of the hippocampus in patients with Alzheimer disease relative to control subjects showed large reductions in hippocampal volumes (approximately 50%) and high sensitivity and specificity for classification.^[36]Over time, enlargement of the temporal horns, as well as of the third and lateral ventricles, was noted in patients with Alzheimer disease as compared with control subjects.

On structural MRI, atrophy of the entorhinal cortex is already present in MCI. In the autosomal dominant forms of Alzheimer disease, the rate of atrophy of the medial temporal structures differentiates affected individuals from control subjects as early as 3 years before the clinical onset of cognitive impairment. The accelerated annual rate of brain atrophy is a surrogate tool for evaluating new therapies in small samples that may save time and resources.

MRI measurements of the hippocampus, amygdala, cingulate gyrus, head of the caudate nucleus, temporal horn, lateral ventricles, third ventricle, and basal forebrain yield a predictive rate of 77% for conversion to Alzheimer disease from questionable Alzheimer disease.^{[37, 38]}

Functional MRI (fMRI) techniques can be used to measure cerebral perfusion. Dynamic susceptibility contrast (DSC) MRI consists of the passage of a concentrated bolus of a paramagnetic contrast agent that sufficiently distorts the local magnetic field to cause a transient loss of signal with pulse sequences, especially T2-weighted sequences. The passage of contrast material is imaged over time by sequential rapid imaging of the same section. In animal studies, the rate of change of signal intensity over time gives a measure directly proportional to cerebral blood volume. Studies in humans have shown a correlation between PET and DSC MRI scan results, as well as between cerebral blood volumes measured with DSC MRI and perfusion on single-photon emission computed tomography (SPECT) scanning.

Studies have been performed using MRI with echo-planar imaging and signal targeting with attenuation radiofrequency (EPISTAR) in patients with Alzheimer disease. Focal areas of hypoperfusion were in the posterior temporoparieto-occipital regions. Ratios of signal intensity in the parieto-occipital and temporo-occipital areas to signal intensity on whole section were significantly lower in the patients with Alzheimer disease than in those without it. The parieto-occipital ratios were not correlated with the severity of dementia, as measured by using the Blessed Dementia Scale Information Memory Concentration subset.

With fMRI, structural imaging can be done by using the same imaging plane, field of view, and section thickness. Activational fMRI studies have included blood oxygenation level–dependent (BOLD) imaging, which uses changes in the level of oxygenated hemoglobin in capillary beds to depict areas of regional brain activation. In Alzheimer disease, fMRI activation in the hippocampal and prefrontal regions is decreased.

On fMRI, paradigms activate a larger area of parietotemporal association cortex in persons at high risk for Alzheimer disease than in others, whereas the entorhinal cortex activation is relatively low in MCI.^[39]

The techniques are reasonably sensitive and specific in differentiating Alzheimer disease from changes resulting from normal aging, and studies with pathologic confirmation show good sensitivity and specificity in differentiating Alzheimer disease from other dementias. These techniques can also be used to detect abnormalities in asymptomatic or presymptomatic individuals, and they may help in predicting the decline to dementia.

Atlthough hippocampal volume has been shown in MRI studies to be associated with cognitive impairment in patients with Alzheimer disease, hippocampal texture has also been shown to be a predictor of conversion of mild cognitive impairment to Alzheimer disease, according to the Alzheimer's Disease Neuroimaging Initiative. ^[40]

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Johnson KA, Fox NC, Sperling RA, Klunk WE. Brain Imaging in Alzheimer Disease. Cold Spring Harb Perspect Med. 2012 Apr. Vol 2:[Medline]. [Full Text].
Iverson DJ, Gronseth GS, Reger MA, Classen S, Dubinsky RM, Rizzo M, et al. Practice parameter update: evaluation and management of driving risk in dementia: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010 Apr 20. 74 (16):1316-24. [Medline].
Rayment D, Biju M, Zheng R, Kuruvilla T. Neuroimaging in dementia: an update for the general clinician. Prog Neurol Psychiatry. 2016 Apr 7. Vol 20:[Full Text].
Nasrallah IM, Wolk DA. Multimodality imaging of Alzheimer disease and other neurodegenerative dementias. J Nucl Med. 2014 Dec. 55 (12):2003-11. [Medline]. [Full Text].
Risacher SL, Saykin AJ. Neuroimaging biomarkers of neurodegenerative diseases and dementia. Semin Neurol. 2013 Sep. 33 (4):386-416. [Medline].
Frisoni GB, Bocchetta M, Chételat G, Rabinovici GD, et al, for ISTAART's NeuroImaging Professional Interest Area. Imaging markers for Alzheimer disease: which vs how. Neurology. 2013 Jul 30. 81 (5):487-500. [Medline].
Atri A. Imaging of neurodegenerative cognitive and behavioral disorders: practical considerations for dementia clinical practice. Handb Clin Neurol. 2016. 136:971-84. [Medline].
Petersen RC, Stevens JC, Ganguli M, et al. Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001 May 8. 56(9):1133-42. [Medline].
[Guideline] Iverson DJ, Gronseth GS, Reger MA, Classen S, Dubinsky RM, Rizzo M, et al. Practice parameter update: evaluation and management of driving risk in dementia: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010 Apr 20. 74 (16):1316-24. [Medline]. [Full Text].
van de Pol LA, Korf ES, van der Flier WM, Brashear HR, Fox NC, Barkhof F. Magnetic resonance imaging predictors of cognition in mild cognitive impairment. Arch Neurol. 2007 Jul. 64(7):1023-8. [Medline].
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul. 34(7):939-44. [Medline].
Montagne A, Nation DA, Pa J, Sweeney MD, Toga AW, Zlokovic BV. Brain imaging of neurovascular dysfunction in Alzheimer's disease. Acta Neuropathol. 2016 May. 131 (5):687-707. [Medline].
Bowman GL, Kaye JA, Moore M, Waichunas D, Carlson NE, Quinn JF. Blood-brain barrier impairment in Alzheimer disease: stability and functional significance. Neurology. 2007 May 22. 68(21):1809-14. [Medline].
Algotsson A, Winblad B. The integrity of the blood-brain barrier in Alzheimer's disease. Acta Neurol Scand. 2007 Jun. 115(6):403-8. [Medline].
Rowe CC, Ng S, Ackermann U, Gong SJ, Pike K, Savage G. Imaging beta-amyloid burden in aging and dementia. Neurology. 2007 May 15. 68(20):1718-25. [Medline].
Rodrigue KM, Kennedy KM, Devous MD Sr, et al. ß-Amyloid burden in healthy aging: regional distribution and cognitive consequences. Neurology. 2012 Feb 1. [Medline].
Carter SF, Scholl M, Almkvist O, et al. Evidence for astrocytosis in prodromal Alzheimer disease provided by 11C-deuterium-L-deprenyl: a multitracer PET paradigm combining 11C-Pittsburgh Compound B and 18F-FDG. J Nucl Med. 2012 Jan. 53(1):37-46. [Medline].
Rabinovici GD, Rosen HJ, Alkalay A, et al. Amyloid vs FDG-PET in the differential diagnosis of AD and FTLD. Neurology. 2011 Dec 6. 77(23):2034-42. [Medline]. [Full Text].
Leuzy A, Carter SF, Chiotis K, Almkvist O, Wall A, Nordberg A. Concordance and Diagnostic Accuracy of [11C]PIB PET and Cerebrospinal Fluid Biomarkers in a Sample of Patients with Mild Cognitive Impairment and Alzheimer's Disease. J Alzheimers Dis. 2015. 45 (4):1077-88. [Medline].
Khan TK, Alkon DL. Alzheimer's Disease Cerebrospinal Fluid and Neuroimaging Biomarkers: Diagnostic Accuracy and Relationship to Drug Efficacy. J Alzheimers Dis. 2015. 46 (4):817-36. [Medline].
Blennow K, Dubois B, Fagan AM, Lewczuk P, de Leon MJ, Hampel H. Clinical utility of cerebrospinal fluid biomarkers in the diagnosis of early Alzheimer's disease. Alzheimers Dement. 2015 Jan. 11 (1):58-69. [Medline].
Jagust WJ, Budinger TF, Reed BR. The diagnosis of dementia with single photon emission computed tomography. Arch Neurol. 1987 Mar. 44(3):258-62. [Medline].
Prados F, Cardoso MJ, Leung KK, Cash DM, Modat M. Measuring brain atrophy with a generalized formulation of the boundary shift integral. Neurobiol Aging. 2015 Jan. Vol 36:S81-S90. [Full Text].
Rana AK, Sandu AL, Robertson KL, McNeil CJ, Whalley LJ, Staff RT, et al. A comparison of measurement methods of hippocampal atrophy rate for predicting Alzheimer's dementia in the Aberdeen Birth Cohort of 1936. Alzheimers Dement (Amst). 2017. 6:31-39. [Medline]. [Full Text].
Bird JM, Levy R, Jacoby RJ. Computed tomography in the elderly: changes over time in a normal population. Br J Psychiatry. 1986 Jan. 148:80-5. [Medline].
Luxenberg JS, Haxby JV, Creasey H, et al. Rate of ventricular enlargement in dementia of the Alzheimer type correlates with rate of neuropsychological deterioration. Neurology. 1987 Jul. 37(7):1135-40. [Medline].
Frackowiak RS, Pozzilli C, Legg NJ, et al. Regional cerebral oxygen supply and utilization in dementia. A clinical and physiological study with oxygen-15 and positron tomography. Brain. 1981 Dec. 104(Pt 4):753-78. [Medline].
Trollor JN, Sachdev PS, Haindl W, et al. Regional cerebral blood flow deficits in mild Alzheimer's disease using high resolution single photon emission computerized tomography. Psychiatry Clin Neurosci. 2005/06. 59(3):280-90.
Maruszak A, Thuret S. Why looking at the whole hippocampus is not enough-a critical role for anteroposterior axis, subfield and activation analyses to enhance predictive value of hippocampal changes for Alzheimer's disease diagnosis. Front Cell Neurosci. 2014. 8:95. [Medline].
Ferris SH, De Leon MJ, Wolf AP. Positron emission tomography in the study of aging and senile dementia. Neurobiol Aging. 1980. 1:127-31.
Del Sole A, Malaspina S, Magenta Biasina A. Magnetic resonance imaging and positron emission tomography in the diagnosis of neurodegenerative dementias. Funct Neurol. 2016 Oct/Dec. 31 (4):205-215. [Medline].
Schouten TM, Koini M, de Vos F, Seiler S, van der Grond J, Lechner A, et al. Combining anatomical, diffusion, and resting state functional magnetic resonance imaging for individual classification of mild and moderate Alzheimer's disease. Neuroimage Clin. 2016. 11:46-51. [Medline].
Lehmann M, Melbourne A, Dickson JC, Ahmed RM, Modat M, Cardoso MJ, et al. A novel use of arterial spin labelling MRI to demonstrate focal hypoperfusion in individuals with posterior cortical atrophy: a multimodal imaging study. J Neurol Neurosurg Psychiatry. 2016 Jan 5. [Medline].
Chow N, Hwang KS, Hurtz S, Green AE, Somme JH, Thompson PM, et al. Comparing 3T and 1.5T MRI for mapping hippocampal atrophy in the Alzheimer's Disease Neuroimaging Initiative. AJNR Am J Neuroradiol. 2015 Apr. 36 (4):653-60. [Medline].
Fox NC, Freeborough PA, Rossor MN. Visualisation and quantification of rates of atrophy in Alzheimer's disease. Lancet. 1996 Jul 13. 348(9020):94-7. [Medline].
Kesslak JP, Nalcioglu O, Cotman CW. Quantification of magnetic resonance scans for hippocampal and parahippocampal atrophy in Alzheimer's disease. Neurology. 1991 Jan. 41(1):51-4. [Medline].
Killiany RJ, Gomez-Isla T, Moss M, Kikinis R, Sandor T, Jolesz F, et al. Use of structural magnetic resonance imaging to predict who will get Alzheimer's disease. Ann Neurol. 2000 Apr. 47(4):430-9. [Medline].
Killiany RJ, Hyman BT, Gomez-Isla T, et al. MRI measures of entorhinal cortex vs hippocampus in preclinical AD. Neurology. 2002 Apr 23. 58(8):1188-96. [Medline].
Machulda MM, Ward HA, Borowski B, Gunter JL, Cha RH, O'Brien PC, et al. Comparison of memory fMRI response among normal, MCI, and Alzheimer's patients. Neurology. 2003 Aug 26. 61(4):500-6. [Medline].
Sørensen L, Igel C, Liv Hansen N, Osler M, Lauritzen M, Rostrup E, et al. Early detection of Alzheimer's disease using MRI hippocampal texture. Hum Brain Mapp. 2016 Mar. 37 (3):1148-61. [Medline].
Scheltens P, Leys D, Barkhof F, Huglo D, Weinstein HC, Vermersch P, et al. Atrophy of medial temporal lobes on MRI in "probable" Alzheimer's disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry. 1992 Oct. 55(10):967-72. [Medline].
Jack CR Jr, Petersen RC, O'Brien PC, Tangalos EG. MR-based hippocampal volumetry in the diagnosis of Alzheimer's disease. Neurology. 1992 Jan. 42(1):183-8. [Medline].
Jack CR Jr, Petersen RC, Xu YC, Waring SC, O'Brien PC, Tangalos EG, et al. Medial temporal atrophy on MRI in normal aging and very mild Alzheimer's disease. Neurology. 1997 Sep. 49(3):786-94. [Medline].
Frisoni GB, Laakso MP, Beltramello A, Geroldi C, Bianchetti A, Soininen H, et al. Hippocampal and entorhinal cortex atrophy in frontotemporal dementia and Alzheimer's disease. Neurology. 1999 Jan 1. 52(1):91-100. [Medline].
Yeo JM, Lim X, Khan Z, Pal S. Systematic review of the diagnostic utility of SPECT imaging in dementia. Eur Arch Psychiatry Clin Neurosci. 2013 Oct. 263 (7):539-52. [Medline].
Johnson KA, Mueller ST, Walshe TM, English RJ, Holman BL. Cerebral perfusion imaging in Alzheimer's disease. Use of single photon emission computed tomography and iofetamine hydrochloride I 123. Arch Neurol. 1987 Feb. 44(2):165-8. [Medline].
DeKosky ST, Shih WJ, Schmitt FA, et al. Assessing utility of single photon emission computed tomography (SPECT) scan in Alzheimer disease: correlation with cognitive severity. Alzheimer Dis Assoc Disord. 1990. 4(1):14-23. [Medline].
Knopman DS, DeKosky ST, Cummings JL, et al. Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001 May 8. 56(9):1143-53. [Medline].
Van Gool WA, Walstra GJ, Teunisse S, Van der Zant FM, Weinstein HC, Van Royen EA. Diagnosing Alzheimer's disease in elderly, mildly demented patients: the impact of routine single photon emission computed tomography. J Neurol. 1995 Jun. 242(6):401-5. [Medline].
Johnson KA, Holman BL, Rosen TJ, Nagel JS, English RJ, Growdon JH. Iofetamine I 123 single photon emission computed tomography is accurate in the diagnosis of Alzheimer's disease. Arch Intern Med. 1990 Apr. 150(4):752-6. [Medline].
Claus JJ, van Harskamp F, Breteler MM, et al. The diagnostic value of SPECT with Tc 99m HMPAO in Alzheimer's disease: a population-based study. Neurology. 1994 Mar. 44(3 Pt 1):454-61. [Medline].
Holman BL, Johnson KA, Gerada B, Carvalho PA, Satlin A. The scintigraphic appearance of Alzheimer's disease: a prospective study using technetium-99m-HMPAO SPECT. J Nucl Med. 1992 Feb. 33(2):181-5. [Medline].
Bonte FJ, Weiner MF, Bigio EH, White CL 3rd. Brain blood flow in the dementias: SPECT with histopathologic correlation in 54 patients. Radiology. 1997 Mar. 202(3):793-7. [Medline].
Marshall GA, Monserratt L, Harwood D, Mandelkern M, Cummings JL, Sultzer DL. Positron emission tomography metabolic correlates of apathy in Alzheimer disease. Arch Neurol. 2007 Jul. 64(7):1015-20. [Medline].
Shimojo M, Higuchi M, Suhara T, Sahara N. Imaging Multimodalities for Dissecting Alzheimer's Disease: Advanced Technologies of Positron Emission Tomography and Fluorescence Imaging. Front Neurosci. 2015. 9:482. [Medline].
de Leon MJ, Convit A, Wolf OT, et al. Prediction of cognitive decline in normal elderly subjects with 2-[(18)F]fluoro-2-deoxy-D-glucose/poitron-emission tomography (FDG/PET). Proc Natl Acad Sci U S A. 2001 Sep 11. 98(19):10966-71. [Medline].
Choi SR, Schneider JA, Bennett DA, Beach TG, Bedell BJ, Zehntner SP, et al. Correlation of amyloid PET ligand florbetapir F 18 binding with Aß aggregation and neuritic plaque deposition in postmortem brain tissue. Alzheimer Dis Assoc Disord. 2012 Jan. 26(1):8-16. [Medline]. [Full Text].
Clark CM, Schneider JA, Bedell BJ, Beach TG, Bilker WB, Mintun MA, et al. Use of florbetapir-PET for imaging beta-amyloid pathology. JAMA. 2011 Jan 19. 305(3):275-83. [Medline].
Fleisher AS, Chen K, Liu X, Roontiva A, Thiyyagura P, Ayutyanont N, et al. Using positron emission tomography and florbetapir F18 to image cortical amyloid in patients with mild cognitive impairment or dementia due to Alzheimer disease. Arch Neurol. 2011 Nov. 68(11):1404-11. [Medline].
US Food and Drug Administration (FDA). FDA approves second brain imaging drug to help evaluate patients for Alzheimer's disease, dementia [press release]. October 25, 2013. Available at http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm372261.htm. Accessed: October 25, 2013.
Neuraceq (florbetaben F 18) prescribing information. [package insert]. Matran Switzerland: Piramal Imaging, S.A. 2014.
Choi SR, Schneider JA, Bennett DA, Beach TG, Bedell BJ, Zehntner SP, et al. Correlation of amyloid PET ligand florbetapir F 18 binding with Aß aggregation and neuritic plaque deposition in postmortem brain tissue. Alzheimer Dis Assoc Disord. 2012 Jan. 26(1):8-16. [Medline]. [Full Text].
Clark CM, Schneider JA, Bedell BJ, Beach TG, Bilker WB, Mintun MA, et al. Use of florbetapir-PET for imaging beta-amyloid pathology. JAMA. 2011 Jan 19. 305(3):275-83. [Medline].
Fleisher AS, Chen K, Liu X, Roontiva A, Thiyyagura P, Ayutyanont N, et al. Using positron emission tomography and florbetapir F18 to image cortical amyloid in patients with mild cognitive impairment or dementia due to Alzheimer disease. Arch Neurol. 2011 Nov. 68(11):1404-11. [Medline].
Silverman DH, Small GW, Chang CY, et al. Positron emission tomography in evaluation of dementia: Regional brain metabolism and long-term outcome. JAMA. 2001 Nov 7. 286(17):2120-7. [Medline].
Salmon E. Functional brain imaging applications to differential diagnosis in the dementias. Curr Opin Neurol. 2002 Aug. 15(4):439-44. [Medline].
Mazziotta JC, Frackowiak RS, Phelps ME. The use of positron emission tomography in the clinical assessment of dementia. Semin Nucl Med. 1992 Oct. 22(4):233-46. [Medline].
Small GW, Ercoli LM, Silverman DH, Huang SC, Komo S, Bookheimer SY, et al. Cerebral metabolic and cognitive decline in persons at genetic risk for Alzheimer's disease. Proc Natl Acad Sci U S A. 2000 May 23. 97(11):6037-42. [Medline].
Reiman EM, Caselli RJ, Chen K, Alexander GE, Bandy D, Frost J. Declining brain activity in cognitively normal apolipoprotein E epsilon 4 heterozygotes: A foundation for using positron emission tomography to efficiently test treatments to prevent Alzheimer's disease. Proc Natl Acad Sci U S A. 2001 Mar 13. 98(6):3334-9. [Medline].
Small GW, Mazziotta JC, Collins MT, et al. Apolipoprotein E type 4 allele and cerebral glucose metabolism in relatives at risk for familial Alzheimer disease. JAMA. 1995 Mar 22-29. 273(12):942-7. [Medline].
Teipel SJ, Kurth J, Krause B, Grothe MJ, Alzheimer's Disease Neuroimaging Initiative. The relative importance of imaging markers for the prediction of Alzheimer's disease dementia in mild cognitive impairment - Beyond classical regression. Neuroimage Clin. 2015. 8:583-93. [Medline].
Aisen PS. The potential of anti-inflammatory drugs for the treatment of Alzheimer's disease. Lancet Neurol. 2002 Sep. 1(5):279-84. [Medline].
Messa C, Perani D, Lucignani G, Zenorini A, Zito F, Rizzo G, et al. High-resolution technetium-99m-HMPAO SPECT in patients with probable Alzheimer's disease: comparison with fluorine-18-FDG PET. J Nucl Med. 1994 Feb. 35(2):210-6. [Medline].
Salmon E, Gregoire MC, Delfiore G, Lemaire C, Degueldre C, Franck G, et al. Combined study of cerebral glucose metabolism and [11C]methionine accumulation in probable Alzheimer's disease using positron emission tomography. J Cereb Blood Flow Metab. 1996 May. 16(3):399-408. [Medline].
Boxer AL, Rabinovici GD, Kepe V, Goldman J, Furst AJ, Huang SC. Amyloid imaging in distinguishing atypical prion disease from Alzheimer disease. Neurology. 2007 Jul 17. 69(3):283-90. [Medline].
Ossenkoppele R, Schonhaut DR, Schöll M, Lockhart SN, Ayakta N, Baker SL, et al. Tau PET patterns mirror clinical and neuroanatomical variability in Alzheimer's disease. Brain. 2016 Mar 8. [Medline].
Doody RS, Stevens JC, Beck C, et al. Practice parameter: management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001 May 8. 56(9):1154-66. [Medline].

Media Gallery

Coronal, T1-weighted magnetic resonance imaging (MRI) scan in a patient with moderate Alzheimer disease. Brain image reveals hippocampal atrophy, especially on the right side.
Axial, T2-weighted magnetic resonance imaging (MRI) scan of the brain reveals atrophic changes in the temporal lobes.
Axial, T2-weighted magnetic resonance imaging (MRI) scan shows dilated sylvian fissure resulting from adjacent cortical atrophy, especially on the right side.
Axial, T1-weighted magnetic resonance imaging (MRI) scan shows a dilated sylvian fissure caused by adjacent cortical atrophy.
Axial, T1-weighted magnetic resonance imaging (MRI) scan shows bilateral cortical atrophy with accentuated cortical sulci; there is decreased involvement in the posterior aspect.
Axial, T1-weighted magnetic resonance imaging (MRI) scan shows bilateral cortical atrophy with accentuated cortical sulci; there is decreased involvement in the posterior aspect.
A slideshow presentation on Alzheimer disease.

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Author

Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS Professor Emeritus of Neurology and Psychiatry, Clinical Professor of Medicine, Clinical Professor of Family Medicine, Clinical Professor of Neurosurgery, State University of New York Upstate Medical University; Neuroscience Director, Department of Neurology, Crouse Irving Memorial Hospital

Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS is a member of the following medical societies: American College of International Physicians, American Heart Association, American Stroke Association, American Academy of Neurology, American Academy of Pain Medicine, American College of Forensic Examiners Institute, National Association of Managed Care Physicians, American College of Physicians, Royal College of Physicians, Royal College of Physicians and Surgeons of Canada, Royal College of Surgeons of England, Royal Society of Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Sally B Zachariah, MD Associate Professor, Department of Neurology, University of South Florida College of Medicine; Director, Department of Neurology, Division of Strokes, Veteran Affairs Medical Center of Bay Pines

Sally B Zachariah, MD is a member of the following medical societies: American Academy of Neurology, American Heart Association, American Society of Neuroimaging

Disclosure: Partner received none from none for none.

Vikas K Agrawal, MD Attending Neurologist, Medical Director of Stroke Unit, Bronx Lebanon Hospital Center; Clinical Instructor, Albert Einstein College of Medicine

Vikas K Agrawal, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association

Disclosure: Nothing to disclose.

Shirish Parikh, MD Consulting Staff, Department of Radiology, Bay Pines Veteran Affairs Medical Center

Disclosure: Nothing to disclose.

Amar Swarnkar, MD, FRCR, MRCPI Director, Interventional Neuroradiology, Director, Neuroradiology Fellowship Program, Assistant Professor, Department of Radiology, State University of New York Upstate Medical University

Amar Swarnkar, MD, FRCR, MRCPI is a member of the following medical societies: American College of Radiology, American Society of Neuroradiology

Disclosure: Nothing to disclose.

Chief Editor

L Gill Naul, MD Professor and Head, Department of Radiology, Texas A&M University College of Medicine; Chair, Department of Radiology, Baylor Scott and White Healthcare, Central Division

L Gill Naul, MD is a member of the following medical societies: American College of Radiology, American Medical Association, American Roentgen Ray Society, Radiological Society of North America

Disclosure: Nothing to disclose.

Acknowledgements

Howard T Chang, MD, PhD Assistant Professor, Department of Pathology, Adjunct Appointments, Departments of Neurology, Neuroscience and Physiology, Assistant Director of Neuropathology, Department of Pathology, State University of New York-Upstate Medical University

Howard T Chang, MD, PhD is a member of the following medical societies: American Association of Neuropathologists, American Society for Clinical Pathology, College of American Pathologists, Massachusetts Medical Society, and Society for Neuroscience

Disclosure: Nothing to disclose.

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