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A national study, the first of its kind, has revealed that a form of brain imaging that detects Alzheimer's "plaques" has a significant influence on the clinical management of patients with mild cognitive impairment and dementia. reports Medical Xpress.
The study found that providing clinicians with the results of
positron emission tomography (PET) that identifies amyloid plaques
in the brain has changed the medical management, including the use of drugs
and advice – in almost two-thirds of cases, more than double what
the researchers predicted in advance of the study. The so-called technique
"Amyloid PET imaging", also changed the diagnosis of the cause of
cognitive impairment in more than one-third of study participants.
The multicenter study of more than 11,000 Medicare beneficiaries,
published April 2, 2019 in the Journal of the American Medical
Association (JAMA), was managed by the American College of Radiology and
led by scientists from the Alzheimer's Association, UC San Francisco,
School of Public Health Brown University, Virginia Commonwealth
University School of Public Health, Washington University School of
Medicine in St. Louis, UC Davis School of Medicine and the Kaiser
Permanent Division of Research.
"We are impressed by the
the magnitude of these findings, which clearly show that amyloid PET imaging
can have a major impact on how we diagnose and treat patients with
Alzheimer's disease and other forms of cognitive decline, "said a study
lead author and principal investigator Gil Rabinovici, MD, Distinguished
Professor of Neurology at the UCSF Memory and Aging Center and Member
from the UCSF Weill Neuroscience Institute.
"These results
present large-scale evidence highly credible as amyloid PET imaging
can be a powerful tool to improve the diagnostic accuracy of Alzheimer's disease
and lead to better medical management, especially in
difficult to diagnose, "said Maria C. Carrillo, Ph.D.
Scientific Officer of the Alzheimer's Association and co-author of
study. "It is important that amyloid PET imaging is more widely
accessible to those who need it. "
Alzheimer's disease is
characterized by the accumulation of amyloid protein plaques and
tau protein "entanglement" in the brain, the presence of which is necessary
for a definitive diagnosis. Until recently, amyloid plaques could only
be detected by post mortem badysis of autopsied brain tissue. With the
advent of amyloid PET, which involves injecting patients with a "tracer"
molecules that stick to amyloid plaques and can be used to visualize
their location in the brain – it became possible to detect plates with a
brain scan and therefore more accurately diagnose people living with the
disease.
Although Alzheimer's disease is not cured,
diagnoses allow doctors to prescribe appropriate management of symptoms
therapies, counseling families on important safety and care planning
problems and direct people to clinical trials to find promising new drugs. he
also enables people with Alzheimer's disease and their families to plan their
the future, including legal and financial issues, and access to resources
and support programs. Results of PET imaging revealing no sign of
The accumulation of amyloid in the brain excludes Alzheimer's disease as a cause
loss of memory, which may lead to an badessment of alternatives and
sometimes reversible causes, such as adverse effects, sleep or
mood disorders and other medical conditions.
However, despite
FDA approval of amyloid PET tracers, use of amyloid PET imaging for
help with the accurate diagnosis of the cause of someone's dementia is
currently not covered by health insurance or health insurance schemes,
unavailable for most people.
Launched in 2016, the IDEAS study (Imaging Dementia – Evidence for Amyloid Scanning) was developed by a team of scientists convened by the Alzheimer's Association to determine whether learning imaging results by amyloid PET would alter the medical management and outcomes for the health of sufferers. memory loss and cognitive decline. IDEAS has recruited nearly 1,000 dementia specialists from 595 sites in the United States and has recruited more than 16,000 Medicare patients with mild cognitive impairment or dementia of uncertain cause. As part of their evidence-based coverage policy, Medicare and Medicaid Services (CMS) service centers repaid amyloid PET testing at 343 facilities and interpreted by more than 700 imaging specialists as part of this initiative. clinical study.
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