Functional MRI Studies in Aging and Early Alzheimer’s Disease: Predicting Clinical Decline
The pathophysiological process of Alzheimer's disease (AD) is thought to begin years, perhaps even decades, prior to the point of clinical diagnosis. Novel functional magnetic resonance imaging (fMRI) techniques have the potential to detect very early brain dysfunction that may predict cognitive decline and subsequent diagnosis of dementia. fMRI studies of subjects at risk for AD have been somewhat inconsistent, with some studies suggesting there may be a period of paradoxical “hyperactivity” very early in the course of prodromal AD, particularly in the hippocampus. It remains unclear whether early functional alterations are compensatory in the setting of early AD pathology or are sensitive indicators of neuronal toxicity. The combination of molecular and functional imaging techniques should prove valuable in elucidating the relationship between AD pathology and brain network dysfunction, and ultimately in predicting clinical decline.
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