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Alzheimer’s Disease

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Imaging Dementia

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Abstract

Main imaging findings:

  • Structural neuroimaging:

    • Computed tomography (CT):

      • Exclusion of alternative pathologies that could explain cognitive impairment and/or behavioral changes.

      • Evaluation of the presence and extent of cerebrovascular disease.

    • Magnetic resonance imaging (MRI):

      • Characteristic reduction of global and regional (temporoparietal) volumes, even in prodromal stages (i.e., mild cognitive impairment and subjective cognitive decline).

      • Evaluation of the presence and extent of cerebrovascular disease with higher accuracy than CT.

      • Characteristic atrophy patterns in late- and early-onset AD presentations.

  • Molecular imaging:

    • SPECT and FDG-PET:

      • Reduction in regional (temporoparietal) blood flow/glucose metabolism, even in prodromal stages (i.e., mild cognitive impairment and subjective cognitive decline).

      • Characteristic hypometabolism patterns in late- and early-onset AD presentations.

      • Abnormal findings are associated with increased risk of progressive cognitive deterioration in mild cognitive impairment.

    • Amyloid PET:

      • High negative predictive value, lower positive predictive value.

      • Low correlation between amyloid burden and neuroanatomy and degree of cognitive performances.

    • Tau PET:

      • High affinity for paired helical filaments of pTau.

      • High spatial correlation of tau burden with FDG-PET hypometabolism distribution and with neuroanatomy of cognitive disturbances.

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Authors and Affiliations

  1. Neuroimaging Research Unit, Division of Neuroscience, Neurology Unit, Neurorehabilitation Unit, Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Massimo Filippi

  2. Vita-Salute San Raffaele University, Milan, Italy

    Massimo Filippi & Federica Agosta

  3. Neuroimaging Research Unit, Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Federica Agosta

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Filippi, M., Agosta, F. (2021). Alzheimer’s Disease. In: Imaging Dementia. Springer, Cham. https://doi.org/10.1007/978-3-030-66773-3_1

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