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Imaging the Aging Brain$
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William Jagust and Mark D'Esposito

Print publication date: 2009

Print ISBN-13: 9780195328875

Published to Oxford Scholarship Online: February 2010

DOI: 10.1093/acprof:oso/9780195328875.001.0001

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Amyloid Imaging and (What is “Normal”?) Aging

Amyloid Imaging and (What is “Normal”?) Aging

Chapter:
(p.191) 14 Amyloid Imaging and (What is “Normal”?) Aging
Source:
Imaging the Aging Brain
Author(s):

William E. Klunk

Chester A. Mathis

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780195328875.003.0014

One thing that has become clear from amyloid imaging studies is how early the full burden of plaques accumulate, often by the time a patient first develops symptoms. This finding brings with it the challenge to define the earliest evidence of plaque accumulation, and this is very likely to be in the clinically unimpaired elderly. We will then need to understand the full significance of asymptomatic brain β-amyloidosis. Does it lead to sub-clinical cognitive deficits? Does it lead to Alzheimer's disease (AD)? If good anti-amyloid therapies can be developed, should they be started at this preclinical stage? Perhaps most importantly, if amyloid deposition can be reversed at this early stage, can AD be prevented? The current paradigm of diagnosing and treating AD during the clinically symptomatic period may not lead us to the treatment success we desire and a new paradigm for the treatment during pre-symptomatic period of AD seems to be required. Amyloid imaging may have its most important application in the detection and longitudinal follow-up of this prodromal state. It may lead to a new definition of what is “normal” aging.

Keywords:   Pittsburgh Compound B, positron emission tomography, amyloid imaging, radiopharmaceuticals, mild cognitive impairment, pathology pharmacokinetic modeling

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