MRI volumes measured over time are valid biomarkers of pathologic progression of Alzheimer's disease across a range of clinical states, according to Oregon researchers.
They suggest that the rate of ventricular volume enlargement can be used to monitor disease progression or response to treatment in future clinical trials that are targeted at neurofibrillary tangles and senile plaque pathology.
Dr. Lisa Silbert and colleagues at the Oregon Health and Sciences University in Portland followed 39 elderly subjects (15 nondemented, 24 with cognitive impairment) for a mean of five years until death. At postmortem, they measured plaque and neurofibrillary tangles in relationship to antemortem MRI.
Total brain volume change over time was related to the accumulation of cortical neurofibrillary tangles, the researchers reported in the August issue of Neurology. The rate of ventricular cerebrospinal fluid volume increase was related to both the neurofibrillary tangles and plaque.
In the nondemented subjects, researchers found no significant relationship between the amount of plaque or tangles and either the total brain or ventricular MRI volume prior to death.
Investigators concluded that the best predictor of cortical neurofibrillary tangles and senile plaque is the rate of ventricular volume increase.
"Whereas the rate of cerebral atrophy was significantly related to neurofibrillary tangle pathology, it was not as sensitive a biomarker as the rate of cerebrospinal fluid volume increase," they said.
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