News | October 14, 2014

MRI Technique Detects Evidence of Cognitive Decline Before Symptoms Appear

October 14, 2014 — A magnetic resonance imaging (MRI) technique can detect signs of cognitive decline in the brain even before symptoms appear, according to a new study published online in the journal Radiology. The technique has the potential to serve as a biomarker in very early diagnosis of preclinical dementia.

The World Health Organization estimates that dementia affects more than 35 million people worldwide, a number expected to more than double by 2030. Problems in the brain related to dementia, such as reduced blood flow, might be present for years but are not evident because of cognitive reserve, a phenomenon where other parts of the brain compensate for deficits in one area. Early detection of cognitive decline is critical, because treatments for Alzheimer’s disease, the most common type of dementia, are most effective in this early phase.

Researchers recently studied arterial spin labeling (ASL), a promising MRI technique that doesn’t require injection of a contrast agent. ASL measures brain perfusion, or penetration of blood into the tissue.

“ASL MRI is simple to perform, doesn’t require special equipment and only adds a few minutes to the exam,” said study author Sven Haller, M.D., from the University of Geneva in Geneva, Switzerland.

The study group included 148 healthy elderly participants and 65 people with mild cognitive impairment (MCI). The participants underwent brain MRI and a neuropsychological assessment, a common battery of tests used to determine cognitive ability.

Of the 148 healthy individuals, 75 remained stable, while 73 deteriorated cognitively at 18 months clinical follow-up. Those who deteriorated had shown reduced perfusion at their baseline ASL MRI exams, particularly in the posterior cingulate cortex, an area in the middle of the brain that is associated with the default mode network, the neural network that is active when the brain is not concentrating on a specific task. Declines in this network are seen in MCI patients and are more pronounced in those with Alzheimer’s disease.

The pattern of reduced perfusion in the brains of healthy individuals who went on to develop cognitive deficits was similar to that of patients with MCI.

“There is a known close link between neural activity and brain perfusion in the posterior cingulate cortex,” Haller said. “Less perfusion indicates decreased neural activity.”

The results suggest that individuals with decreased perfusion detected with ASL MRI may temporarily maintain their cognitive status through the mobilization of their cognitive reserve, but will eventually develop subtle cognitive deficits.

Previous research done with positron emission tomography (PET), the current gold standard for brain metabolism imaging, found that patients with Alzheimer’s disease had reduced metabolism in the same area of the brain where the perfusion abnormalities were found using ASL MRI. This points to a close link between brain metabolism and perfusion, according to Haller.

ASL MRI has potential as a standalone test or as an adjunct to PET for dementia screening, Haller said. While PET can identify markers of Alzheimer’s disease in the brain and cerebrospinal fluid, it exposes the patient to radiation. ASL does not expose the patient to radiation and is easy to perform in routine clinical settings.

“ASL might replace the classic yet unspecific fluordesoxyglucose PET that measures brain metabolism. Instead, PET could be done with the new and specific amyloid PET tracers,” Haller said.

The results also support a role for ASL MRI as an alternative to neuropsychological testing.

The researchers plan to perform follow-up studies on the patient group to learn more about ASL and long-term cognitive changes.

For more information: RadiologyInfo.org

Related Content

Washington University in St. Louis Begins Clinical Treatments With ViewRay MRIdian Linac
News | Image Guided Radiation Therapy (IGRT) | June 14, 2018
June 14, 2018 — The Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in S
PET/CT Changes Care for 59 Percent of Suspected Recurrent Prostate Cancer Cases
News | Prostate Cancer | June 13, 2018
A recently presented investigational clinical trial evaluated the impact of 18F fluciclovine positron emission...
American Society of Neuroradiology Honors Peter Chang with Cornelius G. Dyke Memorial Award
News | Neuro Imaging | June 13, 2018
Peter Chang, M.D., current neuroradiology fellow at UCSF and recently recruited co-director of the UCI Center for...
Accuray TomoTherapy System Beneficial in Two Total Body Irradiation Studies
News | Radiation Therapy | June 13, 2018
Recently published data from two new studies demonstrate the benefits of Accuray’s TomoTherapy System in the delivery...
Women More Likely to Use Other Preventive Health Services Following Mammography
News | Mammography | June 13, 2018
Medicare beneficiaries who undergo breast cancer screening with mammography are more likely than unscreened women to...
Reduced hippocampal volume on MRI

This figure shows reduced hippocampal volume over the course of 6 years as seen on progressive volumetric analysis and also coronal MRI evaluations (arrows).Progressive volume loss in the mesial temporal lobe on MRI is a characteristic imaging feature of AD. This patient was a case of Alzheimer’s Dementia.

 

News | Neuro Imaging | June 12, 2018
According to a UCLA Medical Center study, a new technology shows the potential to help doctors better determine when...
High Prevalence of Atherosclerosis Found in Lower Risk Patients
News | Magnetic Resonance Imaging (MRI) | June 08, 2018
Whole-body magnetic resonance angiography (MRA) found a surprisingly high prevalence of atherosclerosis in people...
Philips Receives FDA 510(k) for Ingenia Elition MR System
Technology | Magnetic Resonance Imaging (MRI) | June 07, 2018
Philips announced that it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for its...
Lung Decision Precision
News | Lung Cancer | June 04, 2018
For smokers and former smokers, the threat of lung cancer always lurks in the shadows.
New Ultrasound Guidelines Reliably Identify Children Who Should be Biopsied for Thyroid Cancer

Image courtesy of Loyola Medicine

News | Pediatric Imaging | May 29, 2018
A Loyola Medicine study has found that new ultrasound guidelines can reliably identify pediatric patients who should be...
Overlay Init