Fast Five Quiz: Alzheimer's Disease Workup

Jasvinder P. Chawla, MD, MBA; Shaheen E. Lakhan, MD, PhD, MS, MEd


September 08, 2023

Along with the evaluation of elements such as patient history and symptoms, CT or MRI should be included in the multidisciplinary workup for Alzheimer's disease. Further, many European countries use CSF biomarkers in the clinical evaluation Alzheimer's disease.

Additionally, the American Academy of Neurology recommends structural neuroimaging with either a noncontrast CT or MRI in the evaluation of patients with dementia. This is primarily to identify lesions that might cause cognitive impairment and rule out potentially treatable causes of progressive cognitive decline, such as chronic subdural hematoma or normal-pressure hydrocephalus. Although brain MRIs or CTs can show diffuse cortical and/or cerebral atrophy in patients with Alzheimer's disease, these findings are typically not considered diagnostic.

Lumbar puncture is recommended only to rule out differential diagnoses such as normal-pressure hydrocephalus or central nervous system infection (eg, neurosyphilis, neuroborreliosis, or cryptococcosis).

Brain single-photon emission CT (SPECT) or PET are not recommended in the routine workup of patients with typical presentations of Alzheimer's disease. However, they might be an appropriate approach in patients with atypical Alzheimer's disease presentations or when a form of frontotemporal dementia is suspected.

In clinical research studies, atrophy of the hippocampi on coronal MRI is considered a valid biomarker of Alzheimer's disease neuropathology. Again, however, this approach is not used in routine diagnosis of Alzheimer's disease.

Learn more about imaging in Alzheimer's disease.


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