MRI and Cognitive Markers of Progression and Risk of Alzheimer Disease
Antemortem, Alzheimer disease (AD) remains a clinical diagnosis because no fully validated biologic markers are available. Consequently, case selection for clinical trials is based on clinical symptoms (impaired cognition, functioning and behavior), coupled with a full history and medical evaluation. Similarly, the demonstration of treatment efficacy in clinical trials requires effects on clinical symptoms or progression. While validated cognitive assessments are accepted markers of disease severity and progression, certain magnetic resonance imaging (MRI) measures (e.g., hippocampal atrophy) correlate well with cognitive assessments in aging and AD, and thus potentially could serve as biologic markers of disease progression. Furthermore, both cognitive tests (particularly decline in delayed recall) and hippocampal atrophy indicate greatly increased risk of AD in nondemented elderly individuals. MRI, therefore, may provide an important adjunct to both selection of “at risk” cases and for tracking disease progression in early AD. In this brief review, these conclusions are supported primarily by results from our Center, but they are consistent with reports from a number of other laboratories.
KeywordsDementia Neurol Hydrocephalus Alan
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