ABSTRACT
The most common cause of severe cognitive impairment in adults is Alzheimer's disease (AD). Depending on the age of onset, AD is divided into early (<65 years) and late (≥65 years) forms. Early-onset AD (EOAD) is significantly less common than later-onset AD (LOAD) and accounts for only about 5-10% of cases. However, its medical and social significance, as a disease leading to loss of ability to work and legal capacity, as well as premature death in patients aged 40-64 years, is extremely high. Patients with EOAD compared with LOAD have a greater number of atypical clinical variants - 25% and 6-12.5%, respectively, which complicates the differential diagnosis of EOAD with other neurodegenerative diseases. However, the typical classical amnestic variant predominates in both EOAD and LOAD. Also, patients with EOAD have peculiarities according to neuroimaging data: when performing MRI of the brain, patients with EOAD often have more pronounced parietal atrophy and less pronounced hippocampal atrophy compared to patients with LOAD. The article pays attention to the features of the clinical and neuroimaging data in patients with EOAD; a case of a patient with EOAD is presented.
Subject(s)
Age of Onset , Alzheimer Disease , Magnetic Resonance Imaging , Neuroimaging , Humans , Alzheimer Disease/diagnostic imaging , Alzheimer Disease/diagnosis , Neuroimaging/methods , Middle Aged , Atrophy/diagnostic imaging , Diagnosis, Differential , Male , Brain/diagnostic imaging , Brain/pathology , Female , Hippocampus/diagnostic imaging , Hippocampus/pathologyABSTRACT
OBJECTIVE: To identify the relationship of neuropsychological changes in patients with Alzheimer's disease (AD) and primary open-angle glaucoma (POAG) and to evaluate the results of magnetic resonance (MR)-morphometry in patients with these diseases. MATERIAL AND METHODS: We examined 32 patients (median age 67 [61.25; 76.75] years, 78.1% women) diagnosed with AD and POAG. The patients were divided into the AD group (n=16) and the POAG group (n=16). Complaints and anamnesis were collected for all patients, neurological status and neuropsychological status were assessed. MRI of the brain, followed by morphometry, was performed. RESULTS: Cognitive impairments (CI) were revealed in patients of both groups. The severity of CI in patients with AD was more pronounced than in patients with POAG (p<0.001). Alzheimer's type of CI was detected in both groups. MR-morphometry revealed a decrease in the volume of the left hippocampus, the volume of the right and left amygdala as well as a decrease in the thickness of the right and left entorhinal cortex in the AD group compared with the POAG group (p<0.05). A significant decrease in the thickness of the right medial orbitofrontal cortex was found in the POAG group compared with the AD group (p<0.05). CONCLUSION: In AD and POAG, there is a similarity of the neuropsychological profile, which reflects the neurodegeneration characteristic of these diseases. MRI morphometry requires an assessment of both volumes and thickness of brain structures. A neuroimaging pattern identified in patients with POAG can be regarded as an indicator of the glaucomatous process.
Subject(s)
Alzheimer Disease , Glaucoma, Open-Angle , Glaucoma , Humans , Female , Aged , Male , Alzheimer Disease/diagnosis , Glaucoma, Open-Angle/diagnosis , Glaucoma, Open-Angle/pathology , Magnetic Resonance Imaging/methods , Glaucoma/pathology , Brain/diagnostic imaging , Brain/pathology , Magnetic Resonance SpectroscopyABSTRACT
The article presents data on biomarkers for the early diagnosis of Alzheimer's disease (AD). Particular attention is paid to potential neuroimaging and ophthalmological markers, such methods of early diagnosis of AD as MRI with post-processing data processing and assessment of the volume of brain structures and cortical thickness - MRI morphometry, as well as optical coherence tomography are described. The article shows the relationship between AD and primary open-angle glaucoma and considers a case of AD in a patient with primary open-angle glaucoma.
