HOW CAN NEUROIMAGING HELP UNDERSTAND, DIAGNOSE, AND

DEVELOP TREATMENTS FOR ALZHEIMER'S DISEASE?

Part C – AD brain scans - anatomical NUCLEAR MEDICINE GRAND ROUNDS

Stanford University

J. Wesson Ashford, M.D., Ph.D.

Clinical Professor (affiliated), Department of Psychiatry and Behavioral SciencesSenior Research Scientist, Stanford / VA Aging Clinical Research

Stanford University and VA Palo Alto Health Care System

January 5, 2010

Slides at: www.medafile.com (Dr. Ashford’s lectures)

BRAIN SCANNING TECHNIQUES

• ANATOMICAL BRAIN IMAGING– CT – cerebral tomography– MRI – magnetic resonance imaging

• FUNCTIONAL BRAIN IMAGING– SPECT – single photon emission computed tomography– PET – FDG – Positron emission tomography

• BRAIN CHEMISTRY MEASUREMENT– MRS (spectroscopy – NAA/Cr: estimate neuronal volume)

• BRAIN PATHOLOGY IMAGING– PIB – amyloid (many compounds under development)– FDDNP – neurofibrillary pathology

Evolution of Neuroimaging in ADEvolution of Neuroimaging in AD• Computed TomographyComputed Tomography• MRIMRI• Volumetric MRIVolumetric MRI• Co-registration of MRICo-registration of MRI• Functional MRIFunctional MRI• FDG Glucose PETFDG Glucose PET• Amyloid ImagingAmyloid Imaging• P-Tau imagingP-Tau imaging

FDG Glucose PET

Lab of Neuro Imaging UCLA School of Medicine. www.loni.ucla.edu/~thompson/AD_4D/dynamic.html.

Helmuth L. Science. 2002;297:1260-1262.

Alzheimer Disease Forum. http://www.alzforum.org/new/detail.asp?id=948.

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NORMAL ALZHEIMER

Hippocampus outline Entorhinal Cortex outline

Braak and Braak stage vs normalized bilateral hippocampal formation (HF) volume in subjects with isolated AD pathology. Jack et al., 2002

Jack et al., 1992HF/TIV = Hippocampal Formation / Total Intracranial Volume

AD-Designed Probability Atlas:Probabilistic Atlas of Hippocampal Volumes

Mega et al. 2002UCLA Medical Center

Future MRIs will include estimates of disease probability based on volumes.

Volumes already being done in some medical centers.