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S4–02–03: Cortical and sub–cortical changes in preclinical and clincial stages of Alzheimer's disease assessed with magnetic resonance imaging
Author(s) -
Teipel Stefan J.,
Schönberg Stefan O.,
Flatz Wilhelm,
Schapiro Marc B.,
Alexander Gene E.,
Reiser Maximilian,
Möller Hans-Jürgen,
Rapoport Stanley I.,
Hampel Harald
Publication year - 2006
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2006.05.272
Subject(s) - basal forebrain , neocortex , cholinergic neuron , entorhinal cortex , neuroscience , atrophy , hippocampus , temporal lobe , neurodegeneration , corpus callosum , medicine , magnetic resonance imaging , pathology , cholinergic , psychology , disease , radiology , epilepsy
insidious onset and progression of decline in at least two cognitive domains. As clinicians and clinical researchers began identifying people at earlier and earlier stages of late life cognitive impairment, characterization of such milder cases no longer met formal criteria for dementia/AD. Mild Cognitive Impairment was the term used to describe a clinical state in which difficulties with memory (MCI-amnestic), or other cognitive domains (MCI-multiple cognitive domains) were greater than that expected for age and education, but did not involve more than one domain or was not below a specific cutoff, e.g, 1.5 standard deviations below the mean for that population. It has been characterized as a ‘risk state’ for development of AD, since individuals with MCI progress and meet the current formal criteria for AD at the rate of approximately 10-15% per year in specialty clinic populations. Objective(s): To review the history of the development of the concept of MCI and the evolution of its definition and meaning over the past several years. Methods: Review of the literature and of current diagnostic and neuropathological methods. Conclusions: MCI associated with insidious development of amnestic syndrome as the primary cognitive impairment evolves to meet formal AD criteria in the vast majority of cases. Emerging neuroimaging and neuropathological studies suggest that the majority of such people already have AD. Because uncommon exceptions occur, such as progressive hippocampal sclerosis, caution is required in making the diagnosis and careful follow-up is necessary. Progressive MCI in other cognitive domains also appears to progress to AD in the majority of cases, but more study of the natural history of this type of MCI is needed, as are biomarkers for earlier detection.