Biomarkers for Alzheimer's disease in sMRI?

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Discussion Overview

The discussion revolves around identifying biomarkers for Alzheimer's disease that can be detected using structural MRI. Participants explore various components such as gray matter, white matter, and cerebrospinal fluid (CSF), while also considering the relevance of amyloid plaques and the complexities of diagnosing Alzheimer's through imaging techniques.

Discussion Character

  • Exploratory
  • Technical explanation
  • Debate/contested

Main Points Raised

  • Some participants propose that gray matter, white matter, and CSF are significant biomarkers detectable by structural MRI.
  • Others mention amyloid plaques as a relevant biomarker for Alzheimer's, questioning whether they can be detected using structural MRI.
  • One participant asserts that amyloid plaques cannot be detected in structural MRI.
  • A participant raises the question of the relationship between changes in gray matter, white matter, and CSF in diagnosing Alzheimer's, seeking a reference value for these components.
  • Another participant emphasizes the complexity of diagnosing Alzheimer's, noting that brain scans alone are insufficient for a definitive diagnosis and that ruling out other conditions is crucial.
  • Some contributions highlight that cognitive testing and patient history are essential in the diagnostic process, as symptoms can overlap with other conditions.
  • Concerns are raised about the limitations of various tests, including CSF examination, which is invasive and may not provide significant insights.

Areas of Agreement / Disagreement

Participants generally agree that there is no definitive method for diagnosing Alzheimer's disease solely through structural MRI, and multiple competing views remain regarding the effectiveness and relevance of different biomarkers.

Contextual Notes

Limitations include the dependence on patient history and cognitive testing, the potential for age-related changes in brain scans, and the challenges in interpreting results due to overlapping symptoms with other conditions.

Kunal Aggarwal
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I have been looking for biomarkers for Alzheimer's disease which can be detected in structural MRI. I have gone through some papers and found that Gray matter, white matter and CSF are good biomarkers. But is there any other except?
 
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Gray matter, white matter and CSF are the main components of the brain and probably encompass most of the structures of the brain that you could examine by structural MRI.
 
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I thought that Amyloid Plaque was thought to be relevant.

Cheers
 
Amyloid plaque is certainly a biomarker for Alzheimer's, but can it be detected with structural MRI?
 
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Ygggdrasil said:
Amyloid plaque is certainly a biomarker for Alzheimer's, but can it be detected with structural MRI?
No, amyloid plaques cannot be detected in structural MRI.
 
Ygggdrasil said:
Gray matter, white matter and CSF are the main components of the brain and probably encompass most of the structures of the brain that you could examine by structural MRI.
That's good. But is there any relation between GM, WM and CSF changes for alzheimer's. Like after processing the MRI images and extracting these features from them, is there any kind of relation among these which can collectively be used to say that "yes this image is having alzheimer's".
Taking it the other way, what value of GM, WM and CSF can we take as a reference for deciding the alzheimer's from MRI image.
 
You are getting into clinical diagnosis. First off, there is no magic bullet to diagnose Alzheimers and some related diseases, it is largely a matter of ruling out other problems. The absolutely definitive diagnosis is an autopsy.
Alzheimer's dementia results from the progressive loss (degeneration) of brain cells. This degeneration may show up in a variety of ways in brain scans.

However, these scans alone aren't enough to make a diagnosis.
From: https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048075

Which is what @Ygggdrasil is trying to tell you.

PLEASE read the whole article. It explains the complexity of the diagnosis. Brain scans can sometimes be helpful - they are just not always absolutely definitive.
 
Yes, there is no definitive way of making the diagnosis, its more like building a case, there are certain typical features of the persons history and difficulties that mean the starting point is in a good history and then some specialist cognitive testing, Alzheimer's is associated with specific patterns of cognitive difficulties but it may also cause some of the other problems with similar symptoms, so its not straight forward, depression for example is commonly present . Then because some of the symptoms can be caused by other problems a number of tests are carried out to exclude these other causes, many can be identified in simple blood tests. Various scans can be used to exclude some possible causes that can be directly imaged like vascular changes or strokes but in reality they don't add much and the cost can only be justified if the diagnosis is still unclear. Any changes that are identified are often age related and present in those without signs of dementia and many of the changes are only seen at the microscopic level. They do remain an important tool in research. Examination of the CSF is rarely used, its invasive and hard to justify though it may indicate the presence of inflammatory proteins, how significant these may be is debatable.
As Alzheimer's tends to run a lengthy course and is essentially untreatable the diagnosis will become clearer over time, the important thing is to identify and treat anything else that might be causing these symptoms or that might add to the persons problems.
 
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