The 1998 Workshop on Neuroimaging Research in Alzheimer's Disease: Observation and issues

In July of 1998, at the Amsterdam meeting of the International Alzheimer's Disease Congress, the first workshop was convened on the Neuroimaging of Alzheimer's Disease. Twenty-two of 24 presenters contributed to this document. Each contributor was asked to summarize a single salient observation on one of four topics: 1) Structural and functional brain imaging and dementia diagnosis; 2) assessment of Alzheimer's disease progression; 3) clinical and post-mortem validation studies; and 4) new and innovative imaging techniques. The summaries show that structural hippocampal formation (hippocampus and entorhinal cortex) changes are the most consistently observed early features of AD. SPECT perfusion studies and PET glucose metabolism studies, with arguably greater disease sensitivity, show the additional involvement of the temporal neocortical metabolism in the early stages of AD. It is offered that imaged changes could serve as biological indicators of disease progression. Progress continues to be made with the differential diagnosis of AD. Further, post mortem studies have been used increasingly to confirm diagnoses and provide anatomical validation for in vivo imaging of the hippocampus and entorhinal cortex. MRI spectroscopy, SPECT and PET studies promise the non-invasive longitudinal examination of brain chemistry and an expansion in the exploration for mechanisms of disease. We anticipate that the next few years will see the standardization of imaging protocols with the adoption of diagnostic imaging criteria for AD and with intervention studies using image derived outcome measures.