title: A critical discussion of the role of neuroimaging in mild cognitive impairment.
abstract: OBJECTIVE
  In this paper, the current neuroimaging literature is reviewed with regard to characteristic findings in mild cognitive impairment (MCI). Particular attention is drawn to the possible value of neuroimaging modalities in the prediction and early diagnosis of Alzheimer's disease (AD).
  
  
  METHODS
  First, the potential contribution of neuroimaging to an early, preclinical diagnosis of degenerative disorders is discussed at the background of our knowledge about the pathogenesis of AD. Second, relevant neuroimaging studies focusing on MCI are explored and summarized. Neuroimaging studies were found through Medline search and by systematically checking through the bibliographies of relevant articles.
  
  
  RESULTS
  Structural volumetric magnetic resonance imaging (MRI) and positron emission tomography (PET)/single photon emission tomography (SPECT) are currently the most commonly used neuroimaging modalities in studies focusing on MCI. There were considerable variations in demographical and clinical characteristics across studies. However, significant hippocampal and entorhinal cortex volume reductions were consistently found in subjects with MCI as compared with cognitively unimpaired controls. While hippocampal and entorhinal cortex atrophy in subjects with MCI are also well-established risk factors for the development of AD, these measures cannot be regarded as being of high predictive value in an individual case. Evidence for other typical neuroimaging changes in MCI is still scarce. In PET and SPECT studies, reduced blood flow and/or glucose metabolism in temporoparietal association areas, posterior cingulate and hippocampus were associated with a higher risk of progressive cognitive decline in MCI. In quantitative electroencephalogram (QEEG), low beta, high theta, low alpha and slowed mean frequency were associated with development of dementia.
  
  
  CONCLUSIONS
  Existing studies suggest that neuroimaging measures have the potential to become valuable tools in the early diagnosis of AD. To establish their value in routine use, larger studies, preferably with long prospective follow-up are needed.
authors.affiliation: Karolinska Institutet, Neurotec, Division of Geriatric Medicine, Huddinge University Hospital, Sweden. wolfh@medizin.uni-leipzig.de
authors.forename: Henrike
authors.initials: H
authors.lastname: Wolf
authors.forename: Vesna
authors.initials: V
authors.lastname: Jelic
authors.forename: Hermann-Josef
authors.initials: HJ
authors.lastname: Gertz
authors.forename: Agneta
authors.initials: A
authors.lastname: Nordberg
authors.forename: Per
authors.initials: P
authors.lastname: Julin
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Wahlund
mesh_terms: D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis*; D001284:Atrophy / Q000150:complications / Q000175:diagnosis; D001921:Brain / Q000000981:diagnostic imaging; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis*; D004569:Electroencephalography; D006801:Humans; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed