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Use of Functional Magnetic Resonance Imaging in the Early Identification of Alzheimer's Disease

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Abstract

A growing body of evidence suggests that a preclinical phase of Alzheimer's disease (AD) exists several years or more prior to the overt manifestation of clinical symptoms and is characterized by subtle neuropsychological and brain changes. Identification of individuals prior to the development of significant clinical symptoms is imperative in order to have the greatest treatment impact by maintaining cognitive abilities and preserving quality of life. Functional magnetic resonance imaging (fMRI) offers considerable promise as a non-invasive tool for detecting early functional brain changes in asymptomatic adults. In fact, evidence to date indicates that functional brain decline precedes structural decline in preclinical samples. Therefore, fMRI may offer the unique ability to capture the dynamic state of change in the degenerating brain. This review examines the clinical utility of blood oxygen level dependent (BOLD) fMRI in those at risk for AD as well as in early AD. We provide an overview of fMRI findings in at-risk groups by virtue of genetic susceptibility or mild cognitive decline followed by an appraisal of the methodological issues concerning the diagnostic usefulness of fMRI in early AD. We conclude with a discussion of future directions and propose that BOLD-fMRI in combination with cerebral blood flow or diffusion techniques will provide a more complete accounting of the neurovascular changes that occur in preclinical AD and thus improve our ability to reliably detect early brain changes prior to disease onset.

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Acknowledgments

This work was supported by NIH R01 AG12674 and P50 AG05131. The authors thank Nikki Horne, Thomas Liu, and Khalid Restom for their invaluable assistance in conducting the case example.

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  1. Department of Psychiatry, University of California San Diego, La Jolla, California, USA

    Christina E. Wierenga & Mark W. Bondi

  2. Psychology Service, VA San Diego Healthcare System, La Jolla, California, USA

    Mark W. Bondi

  3. VA San Diego Healthcare System (116B), 3350 La Jolla Village Drive, San Diego, CA, 92161, USA

    Mark W. Bondi

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Wierenga, C.E., Bondi, M.W. Use of Functional Magnetic Resonance Imaging in the Early Identification of Alzheimer's Disease. Neuropsychol Rev 17, 127–143 (2007). https://doi.org/10.1007/s11065-007-9025-y

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