Brain imaging to be on track for improving diagnosis and pathophysiological insights in neuropsychiatric diseases

Excerpt

Brain imaging techniques are becoming increasingly important in diagnosis and course of neuropsychiatric diseases. This is best demonstrated in dementia, where besides the volumetric investigation of the hippocampus, single-photon emission-computed tomography (SPECT) revealed hyperperfusion patterns in its several subtypes. International guidelines have suggested SPECT to be useful in differentiating several forms of dementia such as Alzheimer’s disease, vascular dementia, frontotemporal dementia and dementia with Lewy bodies. In a meta-analysis and review, Yeo et al. [1] calculated sensitivity and specifity of ^99mTc-HMPAO-SPECT in distinguishing dementia subtypes. They found SPECT investigations of diagnostic value, particularly in differentiating Alzheimer’s dementia from frontotemporal dementia and healthy controls, adding information to the clinical test results. In addition, cerebrospinal fluid (CSF) markers are recommended for dementia diagnosis. Guo et al. [2] investigated protein expression in healthy controls, patients with mild cognitive impairment (MCI) and Alzheimer’s dementia and found heart-type fatty acid-binding protein and vascular endothelial growth factor in CSF to distinguish between patients with Alzheimer’s dementia and healthy controls with lower sensitivity and higher specificity and to predict the progression of MCI to dementia. They recommend combining these markers with the three established markers Amyloid-ß1-42, total-Tau and phosphorylated-Tau, increasing sensitivity to 83 % and specifity to 86 %. …