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Neuroanatomy and Neuroimaging: Application to Alzheimer’s disease diagnosis. Megha Vasavada. Alzheimer’s disease. Most common form of dementia affecting 5.2 million Americans Symptoms: problems with memory, thinking, and behavior As the disease progresses the symptoms intensify

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alzheimer s disease
Alzheimer’s disease
  • Most common form of dementia affecting 5.2 million Americans
  • Symptoms: problems with memory, thinking, and behavior
  • As the disease progresses the symptoms intensify
    • Disorientation
    • mood and behavior changes
    • deepening confusion about events, time and place
    • unfounded suspicions about family, friends and professional caregivers
    • more serious memory loss and behavior changes
    • difficulty speaking, swallowing and walking.
central nervous system
Central Nervous System
  • Controls both voluntary activities and autonomic functions
    • Integrates sensory information, emotions, thoughts, memory, and personality
slide4

Parietal Lobe

Frontal Lobe

  • perception/ integration of somatosensory information (e.g. touch, pressure, temperature, and pain)
  • visuospatial processing
  • spatial attention
  • spatial mapping
  • number representation
  • 'higher' cognitive functions
  • attention
  • thought
  • voluntary movement
  • decision–making
  • language.

Limbic Lobe

Temporal Lobe

  • recognition
  • perception (hearing,
  • vision, smell)
  • understanding language
  • learning and memory

Occipital Lobe

  • Vision

Cerebellum

  • coordination of voluntary movement
  • motor–learning
  • balance and posture
  • reflex memory
  • timing
  • sequence learning
  • integration of sensory information

Brainstem

  • maintaining homeostasis by controlling autonomic functions (blood pressure, breathing, digestion, heart rate, perspiration and temperature)
  • alertness
  • sleep
  • balance
  • startle response

http://www.g2conline.org/2022

slide5

memory formation and storage

  • regulating emotion
  • processing smells

Limbic Lobe

slide6

Frontal Lobe

Parietal Lobe

Occipital Lobe

Temporal Lobe

Cerebellum

Brainstem

Limbic Lobe

slide9

MRI:

  • Visualize structural changes
  • Track neuronal activation by studying blood flow (functional MRI)
olfaction and alzheimer s
Olfaction and Alzheimer’s
  • AD patients in the early stage have deficits in detection, recognition, and memory of an odor
  • AD patients have significantly reduced smell sensitivity
  • Areas involved in olfactory processing are the first areas affected by the classic pathology (Amyloid Beta plaques (Aβ) and neurofibrillary tangles (NFT))
alzheimer s pathology
Alzheimer’s Pathology
  • Amyloid Beta plaques
    • accumulation of Aβ in extracellular space.
  • Neurofibrillary tangles
    • hyperphosphorylated tau accumulation within neurons in the brain

Diagnosis occurs here

overview
Overview
  • Basic neuroanatomy
    • Medial temporal lobe = start of AD patholgy
    • Olfactory areas are in the medial temporal lobe
  • Neuroimaging
    • MRI provides a tool to look at the anatomy and activation in humans

Therefore, we will use MRI to study early changes in AD patients.

hypothesis
Hypothesis
  • Olfactory dysfunction will be present in our two patient groups
  • The volume of the primary olfactory cortex (POC) and hippocampus will be smaller in the two groups
  • The fMRI will show decreased activation in the POC and the hippocampus

Overall- fMRI is more sensitive to earlier changes in MCI and AD patients

subjects
Subjects
  • AD, mild cognitively impaired (MCI), and normal controls were enrolled
    • MCI- considered the transitional stage from normal to AD (important group to study early diagnosis markers)

27 NC 21 MCI 15 AD

methods
Methods
  • Smell test
    • University of Pennsylvania Smell Identification Test
  • MRI:
    • Anatomical scan
    • fMRI scan with an

olfactory task

conclusion
Conclusion
  • UPSIT scores:
    • Smell function is affected in MCI and AD
  • Volume
    • hippocampus and POC in MCI and AD
  • Activation
    • in MCI and AD patients

Activation changes are more drastic than behavioral or volumetric changes in the MCI group