Brain imaging in dementia of the Alzheimer type

Neuroimaging modalities have increased understanding of brain abnormalities in dementia of the Alzheimer type (DAT), and is important in assessment of dementia syndromes by revealing focal disorders, demonstrating potentially treatable conditions, and by documenting progression of disease severity. Computed tomography (CT) and magnetic resonance imaging (MRI) have delineated structural changes in DAT, including cerebral atrophy associated with cortical sulci widening and ventricular enlargement, and deep white-matter lesions with periventricular distributions. Positron emission tomography (PET) has demonstrated diminished regional glucose metabolism at parietal and temporal lobes in DAT, while frontal hypometabolism tends to occur in more severe cases. Metabolic dysfunction assessed by PET appears to be the first indication of a degenerative cortical process in DAT, while anatomic changes on CT or MRI may become evident later in the disease process. This selective overview provides an analysis of the current status and future prospects of brain imaging in DAT.