Alzheimer Disease, Mild Cognitive Impairment, Vascular Dementia
Conditions
Keywords
Neurodegenerative disease, Elderly, Dementia, FDG-PET, MRI, Neuroimaging
Brief summary
The physio-pathology of Alzheimer's disease (AD) remains unknown and there is no cure. Thus, the search for objective markers of preclinical first signs of cognitive impairment, is currently a major public health issue. Early detection of the disease is a major challenge to hope to slow or even stop the neurodegenerative process before the stage of dementia. In AD the investigators observe: * A reduction in the volume of brain hippocampi associated with an alteration of the diffusion of water molecules in the white matter. * A structural brain degeneration coupled with a decrease in cerebral glucose metabolism. Recent publications show that cerebrospinal fluid (CSF)flow is also altered, probably due to dysfunction of the choroid plexus. Hence the potential interest to study is, in addition to conventional imaging, the imaging of CSF dynamics and choroid plexus metabolism. In that aim,the investigators use two imaging modalities: * Magnetic resonance imaging (MRI) is used to assess blood and CSF flow in the brain * Positron emission tomography (PET) is used to assess glucose metabolism in grey/white matter and also in choroid plexus. The investigators expect that, because of choroid plexus atrophy in AD, CSF flow would be altered as well as glucose metabolism dynamic in choroid plexus.
Interventions
OTHERMagnetic resonance imaging
CSF flow measurement at Sylvius' aqueduct and cervical levels. Apparent diffusion coefficient and fractional anisotropy determination in corpus callosum, cingulum and hippocampus.
OTHERPositron emission tomography
Tissue-time activity curves in hippocampus, cingulum, medio-temporal cortex and choroid plexus.
Sponsors
Centre Hospitalier Universitaire, Amiens
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age: over 65 * Participants (or representatives) gave their written informed consent * Dementia diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria * For Alzheimer arm: probable Alzheimer based disease according to NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association ) criteria * For vascular dementia: diagnosis based on NINDS-AIREN (National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences) criteria * For MCI: diagnosis based on Petersen index
Exclusion criteria
* Claustrophobia * Diabetes * Cardiovascular disease * Glycemia over 1.3 g/L * Lumbar puncture within one week before MRI examination * Non MR-compatible implant * Suspected brain metastases * No informed consent signature
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dynamic FDG (fluoro-deoxyglucose) PET | Day 2 | Extraction of tissue time-activity curves ; notably in choroid plexus. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Aqueductal CSF flow | Day 1 | Measurement of CSF flow at the Sylvius' aqueduct level. Calculation of the corresponding stroke volume. |
| Follow-up MRI | Day 365 | MRI examination of MCI patients after one year in order to assess CSF flow differences in MCI how converted to Alzheimer. |
| Follow-up PET | Day 366 | Dynamic FDG PET examination of MCI patients after one year in order to assess FDG dynamic evolution in MCI how converted to Alzheimer. |
Countries
France
Outcome results
None listed