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Related Concept Videos

Alzheimer's Disease: Overview01:26

Alzheimer's Disease: Overview

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Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
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Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
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Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
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Two Routes to Alzheimer's Disease Based on Differential Structural Changes in Key Brain Regions.

Yasmin Hollenbenders1,2,3, Monika Pobiruchin2,4, Alexandra Reichenbach1,2,3

  • 1Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.

Journal of Alzheimer'S Disease : JAD
|March 13, 2023
PubMed
Summary

Alzheimer's disease (AD) progression shows distinct patterns of brain atrophy, identified through neuroimaging. These subtypes, characterized by cortical or limbic deterioration, offer insights into early diagnosis and prognosis.

Keywords:
Alzheimer’s Disease Neuroimaging InitiativeAlzheimer’s diseasebrain atrophyclusteringhidden Markov modellongitudinal datamagnetic resonance imagingpatient stratificationsubtype

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Area of Science:

  • Neuroimaging
  • Neurodegenerative Diseases
  • Biomarkers

Background:

  • Alzheimer's disease (AD) is a neurodegenerative disorder often presenting with homogenous patterns.
  • Neuropathological changes in AD can precede clinical symptoms by up to 20 years.
  • Neuroimaging biomarkers are crucial for early AD diagnosis, prognosis, and patient stratification.

Purpose of the Study:

  • To identify intermediate Alzheimer's disease (AD) stages and their precursors using neuroanatomical features.
  • To stratify patients based on their progression through different AD stages.
  • To link brain atrophy patterns to cognitive decline.

Main Methods:

  • Utilized longitudinal structural MRI data from 1,017 participants (healthy controls and AD patients) from the ADNI database.
  • Extracted grey matter features from 14 brain regions.
  • Modeled AD progression using a Hidden Markov Model with eight distinct disease stages and analyzed ADAS-cog sub-scores.

Main Results:

  • Identified two distinct neuroanatomical progression routes: a cortical route with early atrophy in cortical regions and a limbic route with early atrophy in limbic regions.
  • These routes merged at a final state, with significant cognitive differences noted, particularly in memory, favoring the limbic route.
  • The model revealed differentiable neuroanatomical features across the eight identified states.

Conclusions:

  • Confirmed multiple patterns of grey matter deterioration and distinct stages in Alzheimer's disease (AD) progression.
  • Demonstrated that these neuroanatomical subtypes are behaviorally significant.
  • Highlighted the potential for early AD diagnosis and improved disease progression prognosis using these findings.