中国神经再生研究(英文版) ›› 2021, Vol. 16 ›› Issue (8): 1490-1499.doi: 10.4103/1673-5374.303011

• 综述:退行性病与再生 • 上一篇    下一篇

神经退行性疾病和血管疾病认知功能减退二级预防中的神经影像学应用

  

  • 出版日期:2021-08-15 发布日期:2021-01-13

The neuroimaging of neurodegenerative and vascular disease in the secondary prevention of cognitive decline

Morgan J. Schaeffer, Leona Chan, Philip A. Barber*   

  1. Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
  • Online:2021-08-15 Published:2021-01-13
  • Contact: Philip A. Barber, MD, pabarber@ucalgary.ca.

摘要: https://orcid.org/0000-0002-6051-1078 (Philip A. Barber) 

Abstract: Structural brain changes indicative of dementia occur up to 20 years before the onset of clinical symptoms. Efforts to modify the disease process after the onset of cognitive symptoms have been unsuccessful in recent years. Thus, future trials must begin during the preclinical phases of the disease before symptom onset. Age related cognitive decline is often the result of two coexisting brain pathologies: Alzheimer’s disease (amyloid, tau, and neurodegeneration) and vascular disease. This review article highlights some of the common neuroimaging techniques used to visualize the accumulation of neurodegenerative and vascular pathologies during the preclinical stages of dementia such as structural magnetic resonance imaging, positron emission tomography, and white matter hyperintensities. We also describe some emerging neuroimaging techniques such as arterial spin labeling, diffusion tensor imaging, and quantitative susceptibility mapping. Recent literature suggests that structural imaging may be the most sensitive and cost-effective marker to detect cognitive decline, while molecular positron emission tomography is primarily useful for detecting disease specific pathology later in the disease process. Currently, the presence of vascular disease on magnetic resonance imaging provides a potential target for optimizing vascular risk reduction strategies, and the presence of vascular disease may be useful when combined with molecular and metabolic markers of neurodegeneration for identifying the risk of cognitive impairment. 

Key words: amyloid, arterial spin labeling, cognitive decline, dementia, imaging, magnetic resonance imaging, positron emission tomography, quantitative susceptibility mapping, tau, vascular disease, white matter hyperintensities