Using an algorithm based on structural MRI images, researchers have identified anatomical features that differentiate persons with mild cognitive impairment from those with Alzheimer’s disease.
Three MRI indicators (entorhinal cortex thickness, supramarginal gyrus thickness, and hippocampal volume) correlated with clinical measures of decline and CSF indicators of Alzheimer’s pathology.
The team from MIT, Harvard, and Massachusetts General Hospital used subjects from one collaborative Alzheimer’s imaging database to identify the best MRI indicators, and then validated them using persons in a different brain imaging repository.
The new Alzheimer’s MRI algorithm appears in Brain.
A new report in Neurology identifies clinical predictors of dementia, using over 3000 participants in the Cardiovascular Health Cognition Study.
Dementia developed in over half of those who had high scores, but in only 4% of those with low scores, within 6 years.
The indicators are:
* poor cognitive test performance
* body mass index greater than or equal to18.5
* at least one apolipoprotein E4 allele
* cerebral MRI findings of white matter disease or ventricular enlargement
* ultrasound findings of internal carotid artery thickening
* history of bypass surgery
* slow physical performance
* lack of alcohol consumption
* old age
The “old age” criterion may need refinement when applied to Alzheimer’s, however. A study of brains donated to Britain’s Medical Research Council found that the correlation between dementia and pathological changes associated with Alzheimer’s disease (specifically, plaques and tangles) declines between ages 75 and 95.
RESULT: Age, Neuropathology, and Dementia
New England Journal of Medicine
Radiology tab
Find a different specialist’s perspective on the imaging studies by looking under this tab, which contains the resource collection customized for radiologists.
Here you’ll find a recent article about another way to distinguish mild cognitive impairment from Alzheimer’s using MRI.
RESULT: Volumetric MRI produces early warning on Alzheimer’s disease
Diagnostic Imaging
CME
In this category, there’s a new online CME course about dementia from the Cleveland Clinic.
You might also enjoy quizzing yourself about an obscure neurological sign in the CME-accredited article from Consultant.
RECENT NOTEWORTHY SEARCHES
What other doctors have been finding on SearchMedica
Search term: hydrocephalus
A modeling study explains the poor performance of some shunts for hydrocephalus and suggests a solution, while another report suggests a biomarker for the risk of chronic communicating hydrocephalus after subarachnoid hemorrhage.
RESULT: The physics of hydrocephalus
Pediatric Neurosurgery
RESULT: High CSF transforming growth factor ß levels after subarachnoid haemorrhage: association with chronic communicating hydrocephalus
Journal of Neurology, Neurosurgery, and Psychiatry
Search term: headache
A review from Mayo Clinic explains why migraine should be viewed as a chronic rather than an episodic disorder.
But a neuroscientist argues that the changes in gray matter may be the consequence and not the cause of the pain, and do not necessarily indicate that migraine is a progressive disease.
RESULT: The Future of Migraine: Beyond Just Another Pill
Mayo Clinic Proceedings
RESULT: Morphing voxels: the hype around structural imaging of headache patients
Brain
Search term: cough
An article in a magazine for respiratory therapists reviews the importance of helping patients with neuromuscular disorders to avoid “one of the biggest fears”—catching a cold.
RESULT: Secretion clearance in neuromuscular disease
RT for Decision Makers in Respiratory Care
Search term: phantom limb
The CNS origin of restless legs syndrome is documented by the report of a patient whose symptoms resolved in both the intact and amputated leg, after taking a dopamine agonist.
RESULT: Bilateral restless legs affecting a phantom limb, treated with dopamine agonists
Journal of Neurology, Neurosurgery, and Psychiatry
CLINICAL SEARCH of the week
Lessons from a genuine search result
Someone took the trouble to click a feedback link and express satisfaction with the following report of an experimental study, found with the search term sciatic nerve lesion.
RESULT: Endurance and Resistance Exercise Training Programs Elicit Specific Effects on Sciatic Nerve Regeneration After Experimental Traumatic Lesion in Rats
Neurorehabilitation and Neural Repair
TIP: We know that many doctors, unlike this anonymous searcher, have no interest in seeing animal studies like the one mentioned above.
For PubMed results, SearchMedica has pre-set the filters to exclude animal studies, as well as reports about cellular and molecular research.
However, it’s not possible to be equally selective in filtering content from the clinical journals that SearchMedica indexes directly in the Research/Reviews category. Some non-human studies do find their way into the results.
To identify randomized trials and meta-analyses of human studies only, try the category Evidence-based Articles.
