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Aging is the primary risk factor for dementia. With increasing life expectancy and aging populations worldwide, dementia is becoming one of the most significant public health problems of the century. The most common pathology underlying dementia in older adults is Alzheimer disease (AD). The use of biomarkers is growing in the early detection of AD. Although some biomarkers such as medial temporal lobe volumetry, amyloid positron emission tomography (PET), and Aβ42 in cerebrospinal fluid are being widely used, there is no clear consensus about the best biomarker to be used in each phase of the disease. Magnetic resonance spectroscopy (MRS) of the brain is a less known biomarker, but has proved useful according to cross-sectional and longitudinal studies. This technique measures metabolite levels that reflect the degree of pathology in the brain. Proton MRS may provide a window into the biochemical changes associated with the loss of neuronal integrity and other neurodegenerative pathology that involve the brain before the manifestations of cognitive impairment in patients who are at risk for AD. Longitudinal studies have demonstrated good correlation between N-acetylaspartate levels and progression of AD, even in spite of treatment with cholinesterase inhibitors. Other emergent neuroimaging modalities such as PET with novel ligands, arterial spin labeling magnetic resonance imaging (MRI) and noncerebral blood flow single-photon emission computerized tomography are only discussed briefly. Other structural and functional MRI (diffusion-tensor) have also added interesting contribution to the understanding of the pathophysiology of AD.

DOI: 10.1007/978-3-319-17103-6_28

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