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Test Makes Early Diagnosis of Alzheimer's Disease Possible
Toronto (April 23, 1999) -- A newly developed test can help physicians diagnose patients in the very early stages of Alzheimer's disease, according to a study presented during the American Academy of Neurology 51st Annual Meeting April 17 -- 24, 1999, in Toronto.
"We hope to utilize a new modification of the commonly used imaging technique called MRI (magnetic resonance imaging), to allow us to diagnose patients with mild memory decline in the early stages of Alzheimer's disease," said study author and neurologist Scott Small, MD, of the Sergievsky Center and Columbia Presbyterian Medical Center in New York, NY. "This non-invasive technique, called functional MRI, is able to determine dysfunction in the brain's entorhinal region of the hippocampus, the brain's key structure for controlling memory. Early Alzheimer's disease targets the entorhinal region causing dysfunction that results in memory deficits."
While loss of memory in some elderly could be an early warning sign of Alzheimer's disease, age-related memory decline is common and not everyone with memory loss will develop Alzheimer's. "Both early Alzheimer's disease as well as non-Alzheimer's processes are likely contributing causes of memory decline among non-demented elderly," Small explained. "The brain's hippocampal formation is comprised of different sub-regions. Early Alzheimer's and other causes of memory decline involve the hippocampus, but they affect different regions within that area. We believe patients with dysfunction in the entorhinal region have early Alzheimer's. Those with age-related memory decline have dysfunction in different regions of the hippocampus."
The study participants were selected from a long-term, New York community-based aging project. Subjects, who had never been diagnosed with dementia, Parkinson's disease, stroke or depression, were evaluated for at least three years. Neurological and neuropsychological testing included evaluation of attention, orientation, memory, language ability, and abstract reasoning.
Of the 13 subjects with age-related memory decline, the functional MRI test revealed that five had entorhinal dysfunction and eight had normal entorhinal activity. Those with dysfunction also had greater decline over time in abstract reasoning and language function. "Previous studies have found that poor performance on memory as well as abstract reasoning tests predict progression to Alzheimer's dementia," said Small.
"The most promising research in Alzheimer's disease is targeted at halting progression of the disease as soon as possible," Small said. "We don't anticipate being able to correct the memory and reasoning loss after a patient's full cognitive decline into the disease. Therefore, the earlier we can diagnose and develop treatments for Alzheimer's patients, the better."
Alzheimer's affects about four million people in the United States. Alzheimer's is a debilitating, life-altering disease that attacks the brain, causing progressive memory loss and reasoning. Patients also suffer difficulties with vision, language skills, judgment, personal care skills and emotional control.
The American Academy of Neurology, an association of more than 15,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research.
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Editor's Note: Dr. Small will present the research at the American Academy of Neurology 51st Annual Meeting in Toronto, Canada, during a platform presentation session at 3:45 p.m. on Friday, April 23, 1999, in Room 206BDF of the Metro Toronto Convention Centre.
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