Advanced brain imaging for the diagnosis of Alzheimer disease

Abstract

Purpose of review The purpose is to review the latest advances of brain imaging for the diagnosis of Alzheimer disease (AD). Recent findings Brain imaging techniques provide valuable and complementary information to support the diagnosis of Alzheimer disease in clinical and research settings. The recent FDA accelerated approvals of aducanumab, lecanemab and donanemab made amyloid-PET critical in helping determine the optimal window for anti-amyloid therapeutic interventions. Tau-PET, on the other hand, is considered of key importance for the tracking of disease progression and for monitoring therapeutic interventions in clinical trials. PET imaging for microglial activation, astrocyte reactivity and synaptic degeneration are still new techniques only used in the research field, and more studies are needed to validate their use in the clinical diagnosis of AD. Finally, artificial intelligence has opened new prospective in the early detection of AD using MRI modalities. Summary Brain imaging techniques using PET improve our understanding of the different AD-related pathologies and their relationship with each other along the course of disease. With more robust validation, machine learning and deep learning algorithms could be integrated with neuroimaging modalities to serve as valuable tools for clinicians to make early diagnosis and prognosis of AD.

Ferritin nanocage-enabled detection of pathological tau in living human retinal cells

“…There are currently about 200 active clinical trials worldwide assessing 140 novel treatments for AD, requiring a total enrollment of more than 60,000 participants 1 – 3 . In all clinical trials on AD, inclusion criteria from patient enrollment to concluding evaluation at the end of the study, require careful evaluation of suitable biomarkers 4 . MRI is the most common entry-level analysis collected as an outcome measure, followed by amyloid PET and tau PET 4 – 6 .…”

“…In all clinical trials on AD, inclusion criteria from patient enrollment to concluding evaluation at the end of the study, require careful evaluation of suitable biomarkers 4 . MRI is the most common entry-level analysis collected as an outcome measure, followed by amyloid PET and tau PET 4 – 6 . The current trend for novel clinical trials, however, increasingly requires advances in ultra-sensitive methods to detect proteins in cerebrospinal fluid (CSF) and plasma that enable the identification of pathological changes along the AD continuum.…”