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NUCLEAR MEDICINE GRAND ROUNDS Stanford University J. Wesson Ashford, M.D., Ph.D.

HOW CAN NEUROIMAGING HELP UNDERSTAND, DIAGNOSE, AND DEVELOP TREATMENTS FOR ALZHEIMER'S DISEASE? Part C – AD brain scans - anatomical. NUCLEAR MEDICINE GRAND ROUNDS Stanford University J. Wesson Ashford, M.D., Ph.D.

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NUCLEAR MEDICINE GRAND ROUNDS Stanford University J. Wesson Ashford, M.D., Ph.D.

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  1. HOW CAN NEUROIMAGING HELP UNDERSTAND, DIAGNOSE, AND DEVELOP TREATMENTS FOR ALZHEIMER'S DISEASE?Part C – AD brain scans - anatomical NUCLEAR MEDICINE GRAND ROUNDS Stanford University J. Wesson Ashford, M.D., Ph.D. Clinical Professor (affiliated), Department of Psychiatry and Behavioral Sciences Senior Research Scientist, Stanford / VA Aging Clinical Research Stanford University and VA Palo Alto Health Care System January 5, 2010 Slides at: www.medafile.com(Dr. Ashford’s lectures)

  2. BRAIN SCANNING TECHNIQUES • ANATOMICAL BRAIN IMAGING • CT – cerebral tomography • MRI – magnetic resonance imaging • FUNCTIONAL BRAIN IMAGING • SPECT – single photon emission computed tomography • PET – FDG – Positron emission tomography • BRAIN CHEMISTRY MEASUREMENT • MRS (spectroscopy – NAA/Cr: estimate neuronal volume) • BRAIN PATHOLOGY IMAGING • PIB – amyloid (many compounds under development) • FDDNP – neurofibrillary pathology

  3. Evolution of Neuroimaging in AD Computed Tomography MRI Volumetric MRI Co-registration of MRI Functional MRI FDG Glucose PET Amyloid Imaging P-Tau imaging 39 FDG Glucose PET Helmuth L. Science. 2002;297:1260-1262. Alzheimer Disease Forum. http://www.alzforum.org/new/detail.asp?id=948. Lab of Neuro Imaging UCLA School of Medicine. www.loni.ucla.edu/~thompson/AD_4D/dynamic.html.

  4. NORMAL ALZHEIMER

  5. Hippocampus outline Entorhinal Cortex outline

  6. Braak and Braak stage vs normalized bilateral hippocampal formation (HF) volume in subjects with isolated AD pathology. Jack et al., 2002

  7. Jack et al., 1992 HF/TIV = Hippocampal Formation / Total Intracranial Volume

  8. AD-Designed Probability Atlas:Probabilistic Atlas of Hippocampal Volumes Mega et al. 2002 UCLA Medical Center Future MRIs will include estimates of disease probability based on volumes. Volumes already being done in some medical centers.

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