Alzheimer’s Disease Prevention Initiative.pptVIP

Risk of Developing Alzheimer抯 Disease in Persons with MCI Survival curve of persons characterized as having a mild cognitive impairment for 6 years. Approximately 80% have converted to dementia during this time. Peterson RC, et al., Arch Neurol. 58:1985-1992, 2001. Normal, 75 years old Alzheimer抯 disease, 75 years old Volume of Hippocampus and Rate of Shrinkage Predicts Crossover from MCI to AD Jack CR, et al, Neurology 55: 484-489, 2000 De Leon MJ, 1999 Figure 4. PIB standardized uptake value (SUV) images demonstrate a marked difference between PIB retention in Alzheimers disease (AD) patients and healthy control (HC) subjects. PET images of a 67-year-old HC subject (left) and a 79-year-old AD patient (AD6; MMSE = 21; right). (top) SUV PIB images summed over 40 to 60 minutes; (bottom)18FDG rCMRglc images ( mol/min/100ml). The left column shows lack of PIB retention in the entire gray matter of the HC subject (top left) and normal 18FDG uptake (bottom left). Nonspecific PIB retention is seen in the white matter (top left). The right column shows high PIB retention in the frontal and temporoparietal cortices of the AD patient (top right) and a typical pattern of 18FDG hypometabolism present in the temporoparietal cortex (arrows; bottom right) along with preserved metabolic rate in the frontal cortex. PIB and 18FDG scans were obtained within 3 days of each other. PET Imaging of Amyloid Deposits in Alzheimer抯 Disease vs Normal Controls Source: Klunk, et al. Ann Neurol 2004: 55:306-319. PET imaging with a novel tracer, Pittsburgh Compound-B (PIB), can provide quantitative information on amyloid deposits in living subjects. Current Drug Treatments for AD Acetylcholinesterase inhibitors for mild to moderate AD Tacrine (Cognex) Denepezil (Aricept) Rivastigmine (Exelon) Galantamine (Reminyl) Neuroprotective agent for moderate to severe AD Memantine (Namenda) Funded AD Prevention and Selected Treatment Trials April 2002 Complementary Alternative