title: Applied multimodal diagnostics in a case of presenile dementia.
abstract: BACKGROUND
  Alzheimer's disease (AD) is the most common cause of dementia in the elderly. The possibility of disease-modifying strategies has evoked a need for early and accurate diagnosis. To improve the accuracy of the clinical diagnosis of AD, biomarkers like cerebrospinal fluid (CSF) and neuroimaging techniques like magnetic resonance imaging (MRI) and positron emission tomography (PET) have been incorporated into the diagnostic guidelines of AD.
  
  
  METHODS
  In this case report we outline in reference to one of our patients with presenile dementia the current approaches to the diagnosis of AD. The patient was a 59-year old woman presenting with progressive memory decline. CSF-Aβ42 was normal while P-tau was slightly increased. FDG-PET indicated a pattern typical for AD, amyloid-PET showed an extensive global amyloid load, and tau-PET depicted a pronounced hippocampal tracer accumulation. The MRI scan was rated as normal at routine diagnostics, however quantitative volumetric analysis revealed significant atrophy especially of the parietal lobe. The combination of biomarkers and neuroimaging techniques was therefore suggestive of an underlying AD pathology.
  
  
  CONCLUSIONS
  To enable early and accurate diagnosis of AD and thereby also patient recruitment for anti-tau or anti-β-amyloid therapeutic trials, a combination of biomarkers and neuroimaging techniques seems useful.
authors: Department of Neurology, Ludwig-Maximilians University, Munich, Germany. sonja.schoenecker@med.uni-muenchen.de.
authors: Sonja
authors: http://orcid.org/0000-0003-4499-7861
authors: S
authors: Schönecker
authors: Department of Nuclear Medicine, Ludwig-Maximilians University, Munich, Germany.
authors: Matthias
authors: M
authors: Brendel
authors: Department of Neurology, Ludwig-Maximilians University, Munich, Germany.
authors: Marion
authors: M
authors: Huber
authors: Department of Neurology, Ludwig-Maximilians University, Munich, Germany.
authors: Christian
authors: C
authors: Vollmar
authors: Swiss Epilepsy Center, Zurich, Switzerland.
authors: Hans-Juergen
authors: HJ
authors: Huppertz
authors: Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany.|German Center for Neurodegenerative Diseases, Rostock, Germany.
authors: Stefan
authors: S
authors: Teipel
authors: Department of Pharmacology, Tohoku University School of Medicine, Sendai, Japan.
authors: Nobuyuki
authors: N
authors: Okamura
authors: Department of Neurology, Ludwig-Maximilians University, Munich, Germany.|German Center for Neurodegenerative Diseases, Munich, Germany.
authors: Johannes
authors: J
authors: Levin
authors: Department of Nuclear Medicine, Ludwig-Maximilians University, Munich, Germany.
authors: Axel
authors: A
authors: Rominger
authors: Department of Neurology, Ludwig-Maximilians University, Munich, Germany.
authors: Adrian
authors: A
authors: Danek
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000473:pathology; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid*; D001284:Atrophy / Q000473:pathology; D015415:Biomarkers / Q000134:cerebrospinal fluid; D042241:Early Diagnosis; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006624:Hippocampus / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D059906:Neuroimaging; D010296:Parietal Lobe / Q000473:pathology; D010446:Peptide Fragments / Q000134:cerebrospinal fluid*; D049268:Positron-Emission Tomography; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42); D016875:tau Proteins; D019788:Fluorodeoxyglucose F18
keywords: Alzheimer’s disease; Amyloid-PET; Biomarkers; CSF; Case report; FDG-PET; MRI; tau-PET