Florida scientists say MRI scans can clinically diagnose Alzheimer’s disease by locating changes in the brain, particularly reduced size in the mid-brain region.

“We advocate, based on these findings, that the criteria for the diagnosis of Alzheimer’s disease should include MRI scans,” said Dr. Ranjan Duara, who was the lead author of a study by Florida’s Alzheimer’s Disease Research Center. “By incorporating MRIs into the assessment of patients with memory problems, early diagnosis can be standardized and done far more accurately.”

Duara works at Miami’s Wien Center for Alzheimer’s Disease and Memory Disorders at Mount Sinai Medical Center where he is medical director.

As the most common cause of dementia, Alzheimer’s disease is often indicated by memory loss, disorientation, and deterioration of reading and speaking skills. Because other syndromes or disease’s share these symptoms, often the only way, previously, to confirm Alzheimer’s disease in a patient was by autopsy, which would show the affected brain area.

Previously doctors only used a brain scan to rule out other possible causes of the Alzheimer’s symptoms, such as a stroke.

Researchers studied 260 people in the Miami and Tampa, Florida, areas who were suffering some memory loss. The MRI showed atrophy in the brain regions commonly associated with Alzheimer’s and helped researchers accurately diagnose that the memory loss was from the disease and not from other sources.

Additionally, the study showed that MRIs can spot shrinkage in the brain of people not yet showing signs of Alzheimer’s. These patients began showing this signs as little as two years later, suggesting the scans can be an early predictor of the disease.

The study was funded in part by a National Institute on Aging grant.

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The build up of a certain plaque in the brain may provide an early indicator of the onset of Alzheimer’s disease and give insight as to the causes of memory loss in elderly patients.

“Because of the promise of these therapies, we want to identify people who are at really high risk for the disease, but don’t have symptoms yet,” said William Jagust, a scientist at the University of California-Berkeley Lab’s Life Sciences Division. He was aided in the study by Berkley graduate student Elizabeth Mormino and other scientists. Their work has been published online in the journal Brain.

Their research revealed that the higher the levels of a type of plaque called beta-amyloid that is found in the brain, the more likely that brain is to have a smaller hippocampus. That part of brain is where new memories form. Additionally, a person in this condition will have a more difficult time remembering things connected to specific times and places. This is called “episodic memory,” and examples include recalling what a person had for lunch or where they put their sunglasses.

The presence of the beta-amyloid plaque doesn’t necessarily mean that person will become an Alzheimer’s patient. However, Jagust said when the plaque, episodic memory loss and a reduced hippocampus occur together, it should not be ignored.

“These changes in older people are not necessarily benign. When you start to cluster them together, it begins to sound like Alzheimer’s disease,” he said. “And this suggests that some of the changes we are detecting in normal older people may be indicative of the subsequent development of Alzheimer’s.”

The study was conducted on 20 elderly people who showed no indication of cognitive impairment, and the results conformed to other research on people already suffering from Alzheimer’s. The difference-maker in this project is that it was conducted on “cognitively normal” subjects.

“We wouldn’t say they have they have Alzheimer’s by any stretch of the imagination,” Jagust said. “But the fact that these things occur together makes us consider the possibility that this is a very early change in the brain that could be leading to Alzheimer’s disease.”

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NYU Asst. Prof. Lisa Mosconi

If your mother suffered from Alzheimer’s disease, researches say a brain condition that contributed to it may predispose you as well.

In findings presented to the 2008 Alzheimer’s Association Disease Conference, New York University Research Assistant Professor Lisa Mosconi, said her team found a reduction in glucose brain metabolism in subjects of the study who had a maternal – but not a paternal – history of Alzheimer’s. The results of the study also held true if the subject had no parental history with the disease.

“Our new study shows that subjects with a mother with Alzheimer’s show similarities with Alzheimer’s patients,” Mosconi said. “They have metabolic reductions in the brain regions . . . which worsen over time.”

Researchers tagged glucose in subjects of the study with a chemical that allowed them to trace it using a PET scan. There were 66 participants ranging in age from 52 to 58. Of the subjects, 20 had mothers with Alzheimer’s, 37 had no history and nine had paternal history.

The study followed an earlier, similar research project and adds two years of data. Mosconi said more research is needed. It’s primary contribution is that it sheds light on the role reduced brain metabolism might play in transmitting Alzehimer’s.

The study was conducted by New York University’s Langone Medical Center, Center for Brain Health.

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