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Neuroimaging in DementiaAdam M. Staffaroni, PhD1, Fanny M. Elahi, MD, PhD1, Dana McDermott, DO1, Kacey Marton, MS1, Elissaios Karageorgiou, MD, PhD1,2, Simone Sacco, MD1,3, Matteo Paoletti, MD1,3, Eduardo Caverzasi, MD1,4, Christopher P. Hess, MD, PhD5, Howard J. Rosen, MD1, and Michael D. Geschwind, MD, PhD11Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California2Neurological Institute of Athens, Athens, Greece3Institute of Radiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy4Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy5Division of Neuroradiology, Department of Radiology, University of California, San Francisco (UCSF), CaliforniaAbstractAlthough the diagnosis of dementia still is primarily based on clinical criteria, neuroimaging is playing an increasingly important role. This is in large part due to advances in techniques that can assist with discriminating between different syndromes. Magnetic resonance imaging remains at the core of differential diagnosis, with specific patterns of cortical and subcortical changes having diagnostic significance. Recent developments in molecular PET imaging techniques have opened the door for not only antemortem but early, even preclinical, diagnosis of underlying pathology. This is vital, as treatment trials are underway for pharmacological agents with specific molecular targets, and numerous failed trials suggest that earlier treatment is needed. This article provides an overview of classic neuroimaging findings as well as new and cutting-edge research techniques that assist with clinical diagnosis of a range of dementia syndromes, with an emphasis on studies using pathologically proven cases.Keywordsmagnetic resonance imaging (MRI); positron emission tomography (PET); diffusion tensor imaging (DTI); neurodegenerative diseaseThe diagnosis of dementia is becoming increasingly reliant on a broad range of neuroimaging techniques, and this is reflected in several updated diagnostic criteria.1,2 Neuroimaging enhances the accuracy of diagnoses for distinct dementia subtypes. The recent failures of treatment trials for Alzheimer’s disease (AD)3indicate that earlier Address for correspondence: Michael D. Geschwind, MD, PhD, Department of Neurology, Memory and Aging Center, University of California San Francisco (UCSF), Box 1207, San Francisco, CA 94143-1207 ([email protected]). HHS Public AccessAuthor manuscriptSemin Neurol. Author manuscript; available in PMC 2018 February 22.Published in final edited form as:Semin Neurol. 2017 October ; 37(5): 510–537. doi:10.1055/s-0037-1608808.Author ManuscriptAuthor ManuscriptAuthor ManuscriptAuthor Manuscript
intervention, and therefore earlier diagnosis, may be critical to treatment success. Early diagnosis can be facilitated by neuroimaging techniques that can detect the earliest pathological and metabolic alterations that occur in neurodegenerative disease.

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