Imaging Biomarkers Associated With Cognitive Decline: A Review

Jonathan McConathy, Yvette I. Sheline
2015 Biological Psychiatry  
In evaluating disease changes it is critical to have measurements that are sensitive, specific and reliable. Cognitive decline, particularly in the context of Alzheimer's disease (AD), is an area that has attracted a large number of recent studies, and as such the proposed biomarkers used in these investigations need to be validated. In this review we highlight studies with important implications about the role of imaging biomarkers in cognitive decline and dementia as well as in distinguishing
more » ... preclinical dementia, prior to evidence of cognitive decline. Structural changes determined on magnetic resonance imaging (MRI), both cross-sectional and longitudinal provide early prediction of dementia, particularly when combined with other measures. Molecular imaging using PET and SPECT tracers quantify the presence or activity of receptors, transporters, enzymes, metabolic pathways and proteins. The newest developments in molecular imaging will be described and methods compared. Distinguishing features of imaging biomarkers among dementias and the spectrum of preclinical AD, MCI and AD will be described. Appropriate use criteria for amyloid PET will be delineated. While these efforts are still in the early phase of development, there is great promise for further development in structural MRI and PET technologies. There has been a steadily growing number of studies examining cognitive decline in the elderly. Many of these studies have had a small number of enrollees. It is becoming increasingly important to determine which studies and methods have achieved sufficient sensitivity and specificity that they can guide diagnostic or therapeutic decisions. The papers included in this review were based on Pubmed searches for the terms FDG and dementia, amyloid PET, florbetapir, florbetaben, flutemetamol, PiB, FPCIT, ioflupane, preclinical
doi:10.1016/j.biopsych.2014.08.024 pmid:25442005 pmcid:PMC4362908 fatcat:a4ws6xrpuza5nlawxme6nz3xmu