[Diagnosing the mild cognitive impairment stage of Alzheimer's disease].
Recently, it has become important to diagnose Alzheimer's Disease (AD) at an early stage due to the development of AD therapy. Also, there is increasing recognition of a class of elderly people with complaints of memory loss but who nevertheless do not meet the criteria for dementia. "Mild cognitive impairment" (MCI) is the term used for this disorder, and amnestic MCI is highly converted to AD. In this study we evaluated the accuracy of diagnosis of amnestic MCI by cerebrospinal fluid total-tau protein (CSF/total-tau), cerebrospinal fluid amyloid beta 1-42 protein (CSF/A beta 1-42), and cerebral blood flow in the posterior cingulate cortex using SPECT. CSF/total-tau was the most appropriate to discriminate between normal cognitive individuals and those with amnestic MCI. We also evaluated the CSF/total-tau and MRI images between patients with stable MCI and those with progressive MCI, including those who converted to AD in the following two years. The stable type was characterized by normal CSF/total-tau levels and relatively high grade periventricular white matter lesions (PWML). Conversely, the progressive type was characterized by high CSF-tau levels and relatively low grade PWML. We speculate that stable MCI is due to ischemic change with in the white matter lesion, while progressive MCI may represent a previous stage of AD.
Maruyama
Masahiro
M
Department of Gerontology and Respiratory Medicine, Tohoku University Hospital.
Matsui
Toshifumi
T
Tanji
Haruko
H
Ootsuki
Mari
M
Nemoto
Miyako
M
Tomita
Naoki
N
Okamura
Nobuyuki
N
Matsushita
Sachio
S
Higuchi
Susumu
S
Kodama
Manabu
M
Arai
Hiroyuki
H
Sasaki
Hidetada
H
D000544:Alzheimer Disease / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001921:Brain / Q000473:pathology; D002560:Cerebrovascular Circulation; D003071:Cognition; D019317:Evidence-Based Medicine; D006801:Humans; D008279:Magnetic Resonance Imaging; D008565:Membrane Proteins / Q000235:genetics; D009154:Mutation; D010446:Peptide Fragments / Q000134:cerebrospinal fluid; D053764:Presenilin-1; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon; D016875:tau Proteins / Q000134:cerebrospinal fluid
D016229:Amyloid beta-Peptides; D015415:Biomarkers; D008565:Membrane Proteins; C508853:PSEN1 protein, human; D010446:Peptide Fragments; D053764:Presenilin-1; C075222:amyloid beta-protein (1-42); D016875:tau Proteins