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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Longitudinal CSF and MRI biomarkers improve the diagnosis of mild cognitive impairment
M J de Leon1, S DeSanti, R Zinkowski
1Department of Psychiatry, New York University School of Medicine New York, Center for Brain Health of the Silberstein Institute, NY 10016, USA. mony.deleon@med.nyu.edu
Abstract:
The diagnosis of Alzheimer's disease (AD) in patients with mild cognitive impairment (MCI) is limited because it is based on non-specific behavioral and neuroimaging findings. The lesions of Alzheimer's disease: amyloid beta (Abeta) deposits, tau pathology and cellular oxidative damage, affect the hippocampus in the earlier stages causing memory impairment. In a 2-year longitudinal study of MCI patients and normal controls, we examined the hypothesis that cerebrospinal fluid (CSF) markers for these pathological features improve the diagnostic accuracy over memory and magnetic resonance imaging (MRI)-hippocampal volume evaluations. Relative to control, MCI patients showed decreased memory and hippocampal volumes and elevated CSF levels of hyperphosphorylated tau and isoprostane. These two CSF measures consistently improved the diagnostic accuracy over the memory measures and the isoprostane measure incremented the accuracy of the hippocampal volume achieving overall diagnostic accuracies of about 90%. Among MCI patients, over 2 years, longitudinal hippocampal volume losses were closely associated with increasing hyperphosphorylated tau and decreasing amyloid beta-42 levels. These results demonstrate that CSF biomarkers for AD contribute to the characterization of MCI.
Insights
Diagnosing Alzheimer's disease (AD) in mild cognitive impairment (MCI) is challenging. Cerebrospinal fluid (CSF) biomarkers significantly improve diagnostic accuracy for MCI, aiding early AD characterization.
Area of Science:
- Neurology
- Biochemistry
- Neuroscience
Background:
- Diagnosing Alzheimer's disease (AD) in mild cognitive impairment (MCI) is difficult due to non-specific clinical and imaging findings.
- Key AD pathologies like amyloid beta, tau tangles, and oxidative damage impact the hippocampus early, causing memory loss.
Purpose of the Study:
- To evaluate if cerebrospinal fluid (CSF) biomarkers enhance diagnostic accuracy for MCI compared to memory tests and MRI-hippocampal volume.
- To assess the longitudinal changes in MCI patients over two years.
Main Methods:
- A 2-year longitudinal study comparing MCI patients and healthy controls.
- Analysis of memory performance, MRI-hippocampal volume, and CSF levels of tau, isoprostane, and amyloid beta-42.
Main Results:
- MCI patients exhibited poorer memory, reduced hippocampal volumes, and elevated CSF tau and isoprostane levels compared to controls.
- CSF biomarkers improved diagnostic accuracy, with isoprostane enhancing hippocampal volume accuracy, reaching ~90% overall.
- Longitudinal hippocampal volume loss in MCI correlated with increased tau and decreased amyloid beta-42.
Conclusions:
- CSF biomarkers for Alzheimer's disease (AD) significantly improve the diagnostic characterization of mild cognitive impairment (MCI).
- Combined CSF biomarkers and imaging provide high diagnostic accuracy for MCI, facilitating earlier and more precise diagnosis.
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