Alzheimer and Memory Institute; Research and Resource Memory Centre, AP-HP, Paris, France.
Curr Opin Psychiatry. 2012 Nov;25(6):473-9. doi: 10.1097/YCO.0b013e328357b9ab.
To critically review data on the use of neuroimaging tools in the clinical diagnostic investigation of dementias.
For many years, the use of neuroimaging tools in the evaluation of dementias has been restricted to excluding neurosurgical lesions that may account for the cognitive decline. However, modern neuroimaging extends beyond this traditional role of excluding other conditions and has a key role in the clinical investigation of Alzheimer's disease and of other degenerative cortical dementias. MRI, PET with fluorodeoxyglucose, and single-photon emission computed tomography are topographic markers of neural damage and enable the identification of specific lesional patterns that characterize Alzheimer's disease and other cortical dementias. More recently, PET amyloid markers have enabled the in-vivo assessment of amyloid load, a key feature in the physiopathology of Alzheimer's disease.
The combined use of neuroimaging examinations with clinical, neuropsychological, and cerebrospinal fluid markers can improve the specificity of the diagnosis of Alzheimer's disease, even at early stages of the disease. In the following years, progress in research will provide standardized and validated imaging markers of Alzheimer's disease and other dementias, which may increase their application in clinical settings.
批判性地回顾神经影像学工具在痴呆症临床诊断研究中的应用数据。
多年来，神经影像学工具在评估痴呆症中的应用仅限于排除可能导致认知能力下降的神经外科病变。然而，现代神经影像学超越了这一传统作用，在阿尔茨海默病和其他皮质退行性痴呆的临床研究中具有关键作用。MRI、正电子发射断层扫描（PET）与氟脱氧葡萄糖（FDG）以及单光子发射计算机断层扫描（SPECT）是神经损伤的地形标志物，能够识别出以阿尔茨海默病和其他皮质痴呆为特征的特定病变模式。最近，正电子发射断层扫描（PET）淀粉样蛋白标志物使人们能够对淀粉样蛋白负荷进行体内评估，这是阿尔茨海默病病理生理学的一个关键特征。
神经影像学检查与临床、神经心理学和脑脊液标志物的联合使用可以提高阿尔茨海默病诊断的特异性，即使在疾病的早期阶段也是如此。在未来几年，研究的进展将提供阿尔茨海默病和其他痴呆症的标准化和验证后的影像学标志物，这可能会增加它们在临床环境中的应用。
