Jul 11, 2009

New Structural MRI Test Can Diagnose Alzheimer's and Lewy Body Disease

This is interesting news that is being discussed today at the Alzheimer's Association International Conference on Alzheimer's Disease (ICAD) in Vienna.

A new test called "STructural Abnormality iNDex" or STAND-Map shows great promise in being able to diagnose dementia while patients are alive. The STructural Abnormality iNDexa is a scoring system for MRI images that determines whether someone has Alzheimer's disease, frontotemporal lobar degeneration, and Lewy body disease. The test was developed by looking at autopsied brains and then going back and comparing them to the MRIs of patients. The researchers identified unique patterns in the brain and then developed a scoring system for diagnosis.

Dr. Ron Petersen, director of the Mayo Alzheimer's Disease Research Center, said researchers followed Mayo patients all the way from diagnosis through death.

"Then we got autopsies on them and ... went back and looked at the imaging that had been done," Petersen said. Researchers compared those results with the patients' MRI images that had been taken over the years. Then they developed the new diagnosis technique.

Petersen said researchers made a scoring system for MRI images that determines whether someone has one of the three dementias or not and, if so, which dementia it is.

Mayo Clinic Study Using Structural MRI May Help Accurately Diagnose Dementia Patients

A new Mayo Clinic study may help physicians differentially diagnose three common neurodegenerative disorders in the future. The study will be presented at the Alzheimer's Association International Conference on Alzheimer's Disease on July 11 in Vienna.

In this study, Mayo Clinic researchers developed a framework for MRI-based differential diagnosis of three common neurodegenerative disorders: Alzheimer's disease, frontotemporal lobar degeneration, and Lewy body disease using Structural MRI. Currently, examination of the brain at autopsy is the only way to confirm with certainty that a patient had a specific form of dementia. The framework, which is called "STructural Abnormality iNDex" or STAND-Map, shows promise in accurately diagnosing dementia patients while they are alive. The rationale is that if each neurodegenerative disorder can be associated with a unique pattern of atrophy specific on MRI, then it may be possible to differentially diagnose new patients. The study looked at 90 patients from the Mayo Clinic database who were confirmed to have only a single dementia pathology and also underwent an MRI at the time of clinical diagnosis of dementia. Using the STAND-Map framework, researchers predicted an accurate pathological diagnosis 75 to 80 percent of the time.

"The STAND-Map framework might have great potential in early diagnosis of dementia patients," says Prashanthi Vemuri, Ph.D., a senior research fellow at the Mayo Clinic aging and dementia imaging research lab and lead author of the study. "The next step would be to test the framework on a larger population to see if we can replicate these results and improve the accuracy level we achieved in this proof of concept study. In turn, this may lead to better treatment options for dementia patients."

The senior author of this Mayo Clinic research study is Clifford Jack, M.D. Other members included Kejal Kantarci, M.D.; Matthew L. Senjem; Jeffrey Gunter; Jennifer Whitwell, Ph.D.; Keith Josephs, M.D.; David Knopman, M.D.; Bradley Boeve, M.D.; Tanis Ferman, Ph.D.; Dennis Dickson, M.D.; and Ronald Petersen, Ph.D., M.D.

This work was supported in part by National Institutes of Health (NIH) grants, Robert H. Smith Family Foundation Research Fellowship, Alexander Family Alzheimer's Disease Research Professorship.

About Mayo Clinic

Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. Doctors from every medical specialty work together to care for patients, joined by common systems and a philosophy of "the needs of the patient come first." More than 3,300 physicians, scientists and researchers and 46,000 allied health staff work at Mayo Clinic, which has sites in Rochester, Minn; Jacksonville, Fla; and Scottsdale/Phoenix, Ariz. Collectively, the three locations treat more than half a million people each year. To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic.org/news. For information about research and education visit www.mayo.edu. MayoClinic.com (www.mayoclinic.com) is available as a resource for your health stories.
Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for advice and insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 700 articles with more than 18,000 links on the Internet. Bob resides in Delray Beach, FL.

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