TY - GEN
T1 - Shifting paradigms in dementia toward stratification of diagnosis and treatment using MRI
AU - Van Der Flier, Wiesje M.
AU - Barkhof, Frederik
AU - Scheltens, Philip
PY - 2007/1/1
Y1 - 2007/1/1
N2 - Atrophy and cerebrovascular disease are the two most important magnetic resonance imaging (MRI) characteristics in the evaluation of dementia. On MRI, atrophy is the primary hallmark of neurodegenerative dementias including Alzheimer's disease (AD), while vascular dementia is characterized by the presence of ischemic vascular damage, such as territorial infarcts, lacunes, and white matter hyperintensities. Evidence is accumulating that vascular factors play an important role in the development of cognitive decline at old age and clinical AD. In the present article we present results of four recent MRI studies suggesting the additional involvement of small vessel disease in neurodegenerative disorders. Atrophy in the medial temporal lobe, as typically observed in AD, and small vessel disease often coincide. In terms of clinical significance, their effectsmay even be synergistic. The strict distinction between AD and vascular dementia is often artificial, as most patients suffer from both disorders to some extent. For the future,we see an important role for MRI in identifying those different compartments, regardless of clinical classification. Treatment could be directed by (and evaluated through) MRI patterns, rather than a diagnostic label.
AB - Atrophy and cerebrovascular disease are the two most important magnetic resonance imaging (MRI) characteristics in the evaluation of dementia. On MRI, atrophy is the primary hallmark of neurodegenerative dementias including Alzheimer's disease (AD), while vascular dementia is characterized by the presence of ischemic vascular damage, such as territorial infarcts, lacunes, and white matter hyperintensities. Evidence is accumulating that vascular factors play an important role in the development of cognitive decline at old age and clinical AD. In the present article we present results of four recent MRI studies suggesting the additional involvement of small vessel disease in neurodegenerative disorders. Atrophy in the medial temporal lobe, as typically observed in AD, and small vessel disease often coincide. In terms of clinical significance, their effectsmay even be synergistic. The strict distinction between AD and vascular dementia is often artificial, as most patients suffer from both disorders to some extent. For the future,we see an important role for MRI in identifying those different compartments, regardless of clinical classification. Treatment could be directed by (and evaluated through) MRI patterns, rather than a diagnostic label.
KW - Alzheimer's disease
KW - Atrophy
KW - Cerebrovascular disease
KW - Dementia
KW - Medial temporal lobe
KW - Neurodegenerative disorders
KW - Small vessel disease
KW - White matter hyperintenstities
UR - http://www.scopus.com/inward/record.url?scp=34247624758&partnerID=8YFLogxK
U2 - https://doi.org/10.1196/annals.1379.013
DO - https://doi.org/10.1196/annals.1379.013
M3 - Conference contribution
C2 - 17413024
SN - 1573316598
SN - 9781573316590
T3 - Annals of the New York Academy of Sciences
SP - 215
EP - 224
BT - Imaging and the Aging Brain
PB - Blackwell Publishing Inc.
ER -