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Dementia Prevention Conference
Tell-Tale Signs of Alzheimer’s Can by Detected by
New System
Researchers combined computer program with PET scan
to measure brain metabolism
June 20, 2005 – Researchers said today they have
developed a computer program they call "HipMask" that used with a PET
scan of the brain can possibly detect the tell-tale signs of Alzheimer’s
before the memory robbing disease becomes evident.
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New York University School of Medicine researchers
say they can quickly and accurately measures metabolic activity in a key
region of the brain affected in the early stages of Alzheimer's disease.
Applying the program, they demonstrated that reductions in brain
metabolism in healthy individuals were associated with the later
development of the memory robbing disease.
"This is the first demonstration that reduced
metabolic activity in the hippocampus may be used to help predict future
Alzheimer's disease," says Lisa Mosconi, Ph.D., a research scientist in
the Department of Psychiatry, who developed the computer program and led
the new study. "Although our findings need to be replicated in other
studies," she says, "our technique offers the possibility that we will
be able to screen for Alzheimer's in individuals who aren't cognitively
impaired."
Dr. Mosconi and colleagues have recently published
the technical details of the program, called "HipMask," in the June 2005
issue of the journal Neurology. She presented the new findings today at
the Alzheimer's Association International Conference on Prevention of
Dementia held in Washington.
The computer program is an image analysis technique
that allows researchers to standardize and computer automate the
sampling of PET brain scans. The NYU researchers hope the technique will
enable doctors to measure the metabolic rate of the hippocampus and
detect below-normal metabolic activity.
The technique grew out of years of research by Mony
de Leon, Ed.D., Professor of Psychiatry and Director of the Center for
Brain Health. His group was the first to demonstrate with CT and later
with MRI scans that the hippocampus, a sea-horse shaped area of the
brain associated with memory and learning, diminishes in size as
Alzheimer's disease progresses from mild cognitive impairment to
full-blown dementia.
Yet until now there has been no reliable way to
accurately and quickly measure the hippocampal area of the brain on a
PET scan. The hippocampus is small and its size and shape are affected
greatly in individuals with Alzheimer's, making it difficult to sample
this region. HipMask is a sampling technique that uses MRI to
anatomically probe the PET scan.
MRI relies on electromagnetic energy to excite
water molecules in the brain to create an anatomical map of the brain.
The MRI was used in the study to determine the total volume of the
hippocampus and then to define that portion (namely the HipMask) that
was shared by all persons regardless of their disease status. PET
employs radioactively labeled glucose to show the brain at work and the
HipMask was applied to these scans to derive estimates of the
hippocampal glucose metabolism.
The researchers followed 53 healthy, normal
subjects between the ages of 54 and 80 for at least 9 years and in some
cases for as long as 24 years. All subjects received two FDG-PET scans
-- one at baseline and a follow-up after 3 years. Thirty individuals had
a second follow-up scan after another seven years. Altogether there were
136 PET scans.
The researchers applied the HipMask to all 136
scans. The results showed that hippocampal glucose metabolism, as
determined by the HipMask, was significantly reduced 15% to 40% on the
first scan, compared to controls, of those 25 individuals who would
later experience cognitive decline related to either mild cognitive
impairment or to Alzheimer's. The researchers found that the baseline
hippocampal glucose metabolism was the only brain or clinical measure
that predicted the future cognitive decline.
"Right now, we can show with great accuracy who
will develop Alzheimer's nine years in advance of symptoms, and our
projections suggest we might be able to take that out as far as 15
years," says Dr. de Leon, whose longitudinal study is funded by the
National Institutes of Health (NIH).
"Our basic results will need to be replicated in
other studies and expanded to include PET data from diverse patient
groups," adds Dr. De Leon. "But we're confident this is a strong
beginning, demonstrating accurate detection of early Alzheimer's
disease. Now we have a better tool to examine disease progression, and
we anticipate this might open some doors to prevention treatment
strategies."
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