Title:Integration of Neuroimaging and Molecular Biomarkers in the Diagnosis of Alzheimer’s Disease and Frontotemporal Dementia: The Promise of fMRI
Volume: 22
Issue: 7
Author(s): Joanna Poszwa, Bartosz Słowikowski, Wojciech Owecki, Oliwia Szymanowicz, Pawel P. Jagodzinski, Wojciech Kozubski and Jolanta Dorszewska*
Affiliation:
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
Keywords:
Molecular parameters, neuroimaging factors, dementia, FTD, Alzheimer’s disease, fMRI. *
Abstract:
Introduction: Dementia is a set of acquired and progressive neuropsychiatric disorders.
The most common types of dementia include Alzheimer’s Disease (AD) and Frontotemporal Dementia
(FTD). Early intravital diagnosis of both types of dementia is difficult. Both molecular and
neuroimaging markers are important for the diagnosis of different types of dementia.
Methods: This review employed freely accessible databases, including PubMed, Google Scholar,
and ScienceDirect, using keywords such as molecular parameters, neuroimaging factors, dementia,
FTD, Alzheimer’s disease, and fMRI.
Results: Among the molecular markers of dementia, there are parameters common to its various
types and enabling their differentiation. These parameters include both genetic and biochemical
factors. Markers include genetic factors that help differentiate AD (APP, PSEN1, PSEN2) from
FTD (e.g., TARDBP, FUS, MAPT). Simultaneously, there are important biochemical parameters
differentiating AD (amyloid-beta (Aβ), neurofibrillary tangles) from FTD (TDP-43, FUS, and different
forms of tau protein aggregates). Currently, there is growing interest in neuroimaging
studies in the differential diagnosis of dementia. Positron Emission Tomography (PET) imaging
enables the quantification and localization of Aβ deposits in the brain through the selective binding
of the Pittsburgh Compound-B (PiB) ligand. This method has become the standard in AD diagnostics.
In the context of magnetic resonance imaging studies, it is worth noting the search for
structural differences between AD (mainly affecting the temporal lobe, including the hippocampus
and entorhinal cortex, and the parietal lobe) and FTD (primarily involving the prefrontal cortex,
anterior temporal lobes, and subcortical structures, as well as exhibiting an anteroposterior gradient
of atrophy). However, the method of the future appears to be functional Magnetic Resonance
Imaging (fMRI), especially since functional changes precede structural changes in the development
of dementia.
Discussion: The review encompasses the basic diagnostic criteria for AD and FTD dementia, as
well as molecular and neuroimaging parameters important for the intravital diagnosis of these dementias.
It seems that the use of fMRI can contribute to both early diagnosis and early introduction
of targeted treatment in developing dementia. Although it is not yet widely used clinically, its
diagnostic value is increasingly recognized.
Conclusion: The benefits of fMRI studies complementing molecular markers in the diagnosis of
dementia were highlighted.
