Dang Chun, Wang Yanchao, Li Qian, Lu Yaoheng
Department of Periodical Press, West China Hospital, Sichuan University, Chengdu 610000, China.
Department of Neurology, Chifeng University of Affiliated Hospital, Chifeng 024000, China.
Psychoradiology. 2023 Jun 22;3:kkad009. doi: 10.1093/psyrad/kkad009. eCollection 2023.
Alzheimer's disease (AD) is the most common cause of dementia. Neuropathological changes in AD patients occur up to 10-20 years before the emergence of clinical symptoms. Specific diagnosis and appropriate intervention strategies are crucial during the phase of mild cognitive impairment (MCI) and AD. The detection of biomarkers has emerged as a promising tool for tracking the efficacy of potential therapies, making an early disease diagnosis, and prejudging treatment prognosis. Specifically, multiple neuroimaging modalities, including magnetic resonance imaging (MRI), positron emission tomography, optical imaging, and single photon emission-computed tomography, have provided a few potential biomarkers for clinical application. The MRI modalities described in this review include structural MRI, functional MRI, diffusion tensor imaging, magnetic resonance spectroscopy, and arterial spin labelling. These techniques allow the detection of presymptomatic diagnostic biomarkers in the brains of cognitively normal elderly people and might also be used to monitor AD disease progression after the onset of clinical symptoms. This review highlights potential biomarkers, merits, and demerits of different neuroimaging modalities and their clinical value in MCI and AD patients. Further studies are necessary to explore more biomarkers and overcome the limitations of multiple neuroimaging modalities for inclusion in diagnostic criteria for AD.
阿尔茨海默病(AD)是痴呆最常见的病因。AD患者的神经病理变化在临床症状出现前10 - 20年就已发生。在轻度认知障碍(MCI)和AD阶段,特异性诊断及适当的干预策略至关重要。生物标志物的检测已成为一种有前景的工具,可用于追踪潜在治疗的疗效、进行疾病早期诊断及预判治疗预后。具体而言,多种神经成像模态,包括磁共振成像(MRI)、正电子发射断层扫描、光学成像和单光子发射计算机断层扫描,已提供了一些可供临床应用的潜在生物标志物。本综述中描述的MRI模态包括结构MRI、功能MRI、扩散张量成像、磁共振波谱和动脉自旋标记。这些技术能够在认知正常的老年人脑中检测出症状前诊断生物标志物,也可用于监测临床症状出现后AD疾病的进展。本综述重点介绍了不同神经成像模态的潜在生物标志物、优缺点及其在MCI和AD患者中的临床价值。有必要开展进一步研究以探索更多生物标志物,并克服多种神经成像模态的局限性,从而将其纳入AD的诊断标准。