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New test identifies Alzheimer's hallmarks

Nuclear Brain ImagingA new imaging procedure at ETMC will help doctors' pinpoint key differences between Alzheimer's and other forms of dementia. 

"This is an important step forward in evaluating patients with signs of cognitive impairment," said Dr. George M. Plotkin, PhD,MD, of the ETMC Neurological Institute.

Because a definitive diagnosis of Alzheimer's disease is usually determined upon autopsy, physicians rely on medical history,clinical examination and a variety of diagnostic tools whenevaluating patients.

"Alzheimer's and many varieties of dementia have overlapping symptoms," Dr. Plotkin said.  "A new agent for use in nuclear medicine testing has become available and provides an additional,objective tool for evaluation."

Amyvid™, from Eli Lily, is newly approved by the U.S. Food and Drug Administration. It is the first and only diagnostic agentapproved for imaging of amyloid plaques in a patient'sbrain. 

"Patients with cognitive symptoms should discuss this test withtheir primary care physician to determine if they are candidates,"Dr. Plotkin said.

Since the test is new, it is still under evaluation by Medicare, so patients will want to discuss potential out-of-pocket costs vs.benefits.

"For those patients who are proper candidates, when the test is interpreted by a neuroradiologist and coupled with an appropriate clinical history, the test can provide important diagnostic details," Dr. Plotkin said.

PET scans
PET, or positron emission tomography, scans allow doctors to see how organs are functioning inside the body by delivering color contrast images.

Amyvid, which is mildly radioactive, binds to amyloid plaques in the brain, considered a hallmark characteristic of Alzheimer 's disease. Physicians can get a contrasting view of the presence ofplaques on a computer screen.

A negative Amyvid scan indicates sparse to no amyloid plaques inthe patient's brain  and suggests  a patient's cognitiveimpairment is less likely to be due to Alzheimer 's disease.

A positive Amyvid scan indicates moderate to frequentamyloid plaques are present, and this amount of amyloid plaque is often present in patients with Alzheimer's disease. It may also be present in patients with other types of neurologic conditions and in older people with normal cognition.

Amyvid  is considered an adjunct to other diagnostic evaluations. A positive Amyvid scan does not establish a diagnosis of Alzheimer's disease, or other cognitive disorder.

 "Having this type of data enhances our understanding of apatient's condition, and in the future it will also enhance ourapproach to caring for those with Alzheimer's by providing predictive information on the patient's progression," Dr. Plotkin said. "This scan will also be beneficial as anticipated amyloid plaque-fighting drugs develop. It will be important to know which patients are candidates for clinical trials and ultimately for treatments when those drugs arrive on the market."