Chandrasekar Santosh Kishor, Arthanari Jayanthi, Chandrasekar Kiran Kishor, Gaviria Elizabeth, Shashank Singam, Jethi Achint, John Jobby, Bopparaju Sahana, Potulapati Indra, Mateen Mohammed Abdul, Hussin Omniat Amir
University Hospital Ayr Ayr Scotland.
National Institute for Research in Tuberculosis Chennai Tamil Nadu India.
Health Sci Rep. 2025 Jul 10;8(7):e70855. doi: 10.1002/hsr2.70855. eCollection 2025 Jul.
Neurodegenerative diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), and vascular and frontotemporal dementia (FTD), are characterized by progressive cognitive and motor decline. So, timely detection, especially early in the disease process, is crucial. Positron Emission Tomography (PET), Functional Magnetic Resonance Imaging (fMRI), and Diffusion Tensor Imaging (DTI) are advanced neuroimaging techniques that have shown promise for early diagnosis.
This review evaluates the diagnostic accuracy and clinical utility of PET, fMRI, and DTI in the early detection of neurodegenerative diseases.
A systematic search was conducted using PubMed, Google Scholar, and Cochrane Library for studies published between 2014 and 2024. Inclusion criteria focused on phase 2 and 3 clinical trials involving adult patients with AD, PD, and FTD. Studies were assessed for diagnostic accuracy, sensitivity, specificity, and identification of early biomarkers using PET, fMRI, and DTI. Data were extracted and analyzed from 14 selected studies.
PET imaging with tracers like 18F-flortaucipir provided visualization of amyloid and tau aggregates in AD and dopaminergic changes in PD. PET showed a strong association with amyloid and tau pathology in AD, with up to 95% diagnostic performance. Another useful technique in identifying early changes in the brain networks was resting-state fMRI (rs-fMRI), with a diagnostic accuracy of 80%-95%. DTI offered essential data on white matter connectivity and showed microstructural alterations that pointed to early neurodegenerative processes. Integrating these neuroimaging modalities with machine learning models further enhanced diagnostic accuracy.
PET, fMRI, and DTI are valuable tools for the early diagnosis of neurodegenerative diseases. These techniques can identify structural and functional changes in the brain before the onset of clinical signs. Integrating these imaging techniques with machine learning improves diagnostic outcomes. Further large-scale studies with standardized methodologies are needed to validate these findings and implement these techniques in clinical practice.
神经退行性疾病，包括阿尔茨海默病（AD）、帕金森病（PD）以及血管性和额颞叶痴呆（FTD），其特征为进行性认知和运动功能衰退。因此，及时检测，尤其是在疾病进程的早期进行检测，至关重要。正电子发射断层扫描（PET）、功能磁共振成像（fMRI）和弥散张量成像（DTI）是先进的神经成像技术，已显示出在早期诊断方面的前景。
本综述评估PET、fMRI和DTI在神经退行性疾病早期检测中的诊断准确性和临床实用性。
使用PubMed、谷歌学术和考克兰图书馆对2014年至2024年发表的研究进行系统检索。纳入标准集中于涉及AD、PD和FTD成年患者的2期和3期临床试验。评估研究使用PET、fMRI和DTI的诊断准确性、敏感性、特异性以及早期生物标志物的识别情况。从14项选定研究中提取并分析数据。
使用18F-氟替卡匹尔等示踪剂的PET成像可显示AD中淀粉样蛋白和tau蛋白聚集体以及PD中的多巴胺能变化。PET显示与AD中的淀粉样蛋白和tau蛋白病理有很强的关联，诊断性能高达95%。静息态功能磁共振成像（rs-fMRI）是识别脑网络早期变化的另一项有用技术，诊断准确性为80%-95%。DTI提供了关于白质连通性的重要数据，并显示出指向早期神经退行性过程的微观结构改变。将这些神经成像模式与机器学习模型相结合可进一步提高诊断准确性。
PET、fMRI和DTI是神经退行性疾病早期诊断的宝贵工具。这些技术可在临床症状出现之前识别大脑的结构和功能变化。将这些成像技术与机器学习相结合可改善诊断结果。需要进一步开展采用标准化方法的大规模研究来验证这些发现并将这些技术应用于临床实践。
