ICAD: MRI map may help diagnose dementia disorders

Physicians may be able to differentially diagnose three common neurodegenerative disorders via MRI in the near future, according to a study presented at the Alzheimer's Association International Conference on Alzheimer's Disease (ICAD) on July 11 in Vienna.

Mayo Clinic researchers have 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, exam 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 the STructural Abnormality iNDex (STAND)-Map, showed promise in accurately diagnosing dementia patients while they are alive, according to the investigators. 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 that were confirmed to have only a single dementia pathology and also underwent an MRI at the time of their clinical diagnosis. 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," said the study's lead author, Prashanthi Vemuri, PhD, a senior research fellow at the Mayo Clinic aging and dementia imaging research lab in Rochester, Minn.

"We see a great potential for STAND scores," she said. "It could be used for early identification of Alzheimer's disease, for tracking the progression and assessing the severity of Alzheimer's disease in patients, and in the future, it could potentially help test the efficacy of drugs used to treat Alzheimer's disease. 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.

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