Seeing is believing: neuroimaging adds to our understanding of cerebral pathology

Purpose of review Recent technological developments in neuroimaging have led to new technologies that provide measures of the cerebral pathology of neurodegeneration in living humans. The purpose of this review is to provide background behind these developments and update readers on new findings. Recent findings Several imaging methods using positron emission tomography have provided measures of amyloid senile plaques in the brain of demented patients and patients with early memory symptoms. ([F-18]FDDNP)-positron emission tomography provides measures of both amyloid plaques and neurofibrillary tangles. Initial results indicate that the pattern of binding values in Alzheimer's disease is consistent with the known neuropathology from autopsy studies, and patients with mild cognitive impairment, who are at risk of Alzheimer's disease, show binding values intermediate between Alzheimer's disease and normal aging. 2-(1-{6-[(2-[F-18]Fluoroethyl)(methyl)amino]-2-naphthyl} ethylidene)malononitrile ([F-18]FDDNP) positron emission tomography also shows a pattern of neuropathology distribution for frontotemporal dementia that differs from that of Alzheimer's disease. Summary In-vivo imaging of cerebral pathology offers the potential for more effective and earlier diagnosis and use of these technologies as surrogate markers to test novel treatments aimed at preventing or eliminating cerebral plaque and tangle accumulation.