Staffaroni Adam M, Elahi Fanny M, McDermott Dana, Marton Kacey, Karageorgiou Elissaios, Sacco Simone, Paoletti Matteo, Caverzasi Eduardo, Hess Christopher P, Rosen Howard J, Geschwind Michael D
Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California.
Neurological Institute of Athens, Athens, Greece.
Semin Neurol. 2017 Oct;37(5):510-537. doi: 10.1055/s-0037-1608808. Epub 2017 Dec 5.
Although the diagnosis of dementia still is primarily based on clinical criteria, neuroimaging is playing an increasingly important role. This is in large part due to advances in techniques that can assist with discriminating between different syndromes. Magnetic resonance imaging remains at the core of differential diagnosis, with specific patterns of cortical and subcortical changes having diagnostic significance. Recent developments in molecular PET imaging techniques have opened the door for not only antemortem but early, even preclinical, diagnosis of underlying pathology. This is vital, as treatment trials are underway for pharmacological agents with specific molecular targets, and numerous failed trials suggest that earlier treatment is needed. This article provides an overview of classic neuroimaging findings as well as new and cutting-edge research techniques that assist with clinical diagnosis of a range of dementia syndromes, with an emphasis on studies using pathologically proven cases.
尽管痴呆症的诊断仍主要基于临床标准,但神经影像学正发挥着越来越重要的作用。这在很大程度上归因于能够辅助区分不同综合征的技术进步。磁共振成像仍然是鉴别诊断的核心,皮质和皮质下变化的特定模式具有诊断意义。分子PET成像技术的最新进展不仅为生前诊断,也为潜在病理学的早期甚至临床前诊断打开了大门。这至关重要,因为针对具有特定分子靶点的药物制剂的治疗试验正在进行,而且众多失败的试验表明需要更早进行治疗。本文概述了经典的神经影像学发现以及有助于一系列痴呆综合征临床诊断的新的和前沿研究技术,重点是使用病理证实病例的研究。