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Alzheimer disease is a chronic, progressive, and irreversible neurodegenerative disorder and the most common cause of dementia in older adults. It leads to gradual neuronal loss, causing cognitive decline, behavioral changes, and loss of functional independence.Risk Factors and EtiologyThe disease is multifactorial. Age is the strongest risk factor, with prevalence doubling every 5 years after age 65. Genetic factors include mutations in genes such as APP, PSEN1, and PSEN2, which are associated...
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Alzheimer disease involves structural changes in the brain that begin long before symptoms appear. The most distinctive features are extracellular neuritic plaques and intracellular neurofibrillary tangles.Neuritic plaques form in the cerebral cortex and around blood vessels. These plaques contain a dense core of beta-amyloid (Aβ)—a toxic protein fragment that clumps outside neurons. The core is surrounded by damaged neuronal extensions, as well as reactive astrocytes and...
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Updated: May 5, 2026

Lesion Explorer: A Video-guided, Standardized Protocol for Accurate and Reliable MRI-derived Volumetrics in Alzheimer's Disease and Normal Elderly
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Olfactory Testing and Gray Matter Volume: A Combined Approach to Predict the Conversion to Alzheimer.

Claudia Casadio1, Daniela Ballotta1, Francesco Ricci1

  • 1Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy.

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Summary

Olfactory decline and brain atrophy in Mild Cognitive Impairment (MCI) can predict Alzheimer's disease (AD) progression. Early olfactory and morphological assessments in MCI patients may enable timely interventions.

Keywords:
Alzheimer’s iseaseMild Cognitive Impairmentmemoryolfaction

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Area of Science:

  • Neuroscience
  • Neurology
  • Gerontology

Background:

  • Olfactory decline is a common aging symptom and is prevalent in neurodegenerative diseases like Alzheimer's disease (AD).
  • Olfactory deficits are proposed as potential early markers for Mild Cognitive Impairment (MCI) progression to AD.
  • The link between olfactory dysfunction, brain atrophy, and MCI conversion to AD requires further investigation.

Purpose of the Study:

  • To investigate olfactory-related morphological and behavioral changes in MCI patients.
  • To determine if these changes can predict MCI progression to AD.
  • To explore the relationship between olfactory deficits and cerebral atrophy in MCI.

Main Methods:

  • Study included 27 MCI patients (13 converters to AD - cMCI, 14 stable - sMCI) and 35 healthy controls (HCs).
  • Olfactory function was assessed using the Burgarth Sniffin' Sticks Tests (threshold, discrimination, identification).
  • Brain structure was analyzed using Voxel-Based Morphometry (VBM) to identify patterns of cerebral atrophy.

Main Results:

  • Olfactory discrimination and identification tests differentiated HC from MCI and cMCI from sMCI.
  • Olfactory performance correlated with memory in stable MCI and with executive functions in converters.
  • VBM revealed distinct atrophic patterns in the olfactory cortex of cMCI patients predating AD conversion, correlating with cognitive functions.

Conclusions:

  • Quantitative olfactory and morphological patterns serve as non-invasive biomarkers for MCI progression to AD.
  • Assessing these patterns at MCI onset allows for earlier detection and intervention.
  • These findings support the use of olfactory and brain imaging for predicting AD development in MCI patients.