title: Relevance of functional neuroimaging in the progression of mild cognitive impairment.
abstract: OBJECTIVE
  To assess whether combining neuropsychological tests and cerebral blood flow markers improves progression accuracy from mild cognitive impairment (MCI) to Alzheimer's disease (AD) than each of them on its own.
  
  
  METHODS
  Forty-two patients were investigated prospectively, undergoing baseline and 3-year follow-up neuropsychological tests and neuroimaging with Tc-ECD-SPECT. Twenty-one patients had developed AD while 21 retained their initial diagnosis. The relative blood flow and cognitive differences were studied. Validity parameters, multivariant analysis and logistic regression model were calculated.
  
  
  RESULTS
  Patients who deteriorated showed lower scoring than stable subjects in some neuropsychological tests (p = 0.03-0.001) and in relative blood flow in selected regions (8-10%). Low cognitive test scoring and low relative blood flow in some regions showed sensibilities and specificities from 70% to 86% for the diagnosis of early Alzheimer's disease. The relative risk of progression to AD was up to 4.7 times higher for these patients (p = 0.0001). The left frontal relative blood flow, the CAMCOG and orientation scoring were the best data to predict the risk of progression to AD.
  
  
  CONCLUSIONS
  The combination of functional imaging and neuropsychological tests can diagnose with high sensitivity and specificity if a patient is suffering cognitive impairment in its early stages, and may aid in predicting the risk of developing dementia.
authors.affiliation: Department of Nuclear Medicine, Hospital Clínico San Carlos, Madrid, Spain. jcabranes.hcsc@salud.madrid.org
authors.forename: José A
authors.initials: JA
authors.lastname: Cabranes
authors.forename: Ramón
authors.initials: R
authors.lastname: De Juan
authors.forename: Marta
authors.initials: M
authors.lastname: Encinas
authors.forename: Alberto
authors.initials: A
authors.lastname: Marcos
authors.forename: Pedro
authors.initials: P
authors.lastname: Gil
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernández
authors.forename: Carmen
authors.initials: C
authors.lastname: De Ugarte
authors.forename: Ana
authors.initials: A
authors.lastname: Barabash
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000523:psychology; D003545:Cysteine / Q000031:analogs & derivatives*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D009483:Neuropsychological Tests; D015609:Organotechnetium Compounds; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; C059659:technetium Tc 99m bicisate; D003545:Cysteine