Ressonância magnética multimodal de pacientes com comprometimento cognitivo leve

Cui, Yu; Liu, Chenglong; Wang, Ying; Xie, Hongyan

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Dementia & Neuropsychologia

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Sumário

View & Review • Dement. neuropsychol. 17 • 2023 • https://doi.org/10.1590/1980-5764-DN-2023-0017 copiar

Ressonância magnética multimodal de pacientes com comprometimento cognitivo leve

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

O avanço da tecnologia de neuroimagem oferece uma referência fundamental para a detecção precoce do comprometimento cognitivo leve (CCL), uma área significativa de foco na pesquisa contemporânea da função cognitiva. A ressonância magnética estrutural apresenta manifestações visuais e quantitativas de alterações no tecido cerebral, enquanto a ressonância magnética funcional retrata o estado metabólico e funcional dos tecidos cerebrais sob diversas perspectivas. Como várias técnicas de ressonância magnética possuem pontos fortes e restrições, esta revisão examinou as metodologias e os resultados da tecnologia de ressonância magnética multimodal no diagnóstico de CCL, estabelecendo as bases para intervenções diagnósticas e terapêuticas subsequentes para CCL.

Palavras-chave:
Imageamento por Ressonância Magnética; Disfunção Cognitiva; Diagnóstico Precoce

Imaging modality	Advantages	Disadvantages
sMRI	Using sMRI, MCI can be categorized based on brain structure, such as early-stage hippocampal and medial temporal lobe atrophy. This classification aids in predicting the specific type and risk of dementia. Additionally, sMRI can assist in evaluating the effectiveness of therapeutic medications.	Limitations of sMRI include its low sensitivity and specificity in diagnosing MCI. As a result, it cannot independently and precisely predict the progression from MCI to AD.
fMRI	This technique is non-invasive, straightforward, and provides enhanced spatial and temporal resolution. The activation patterns of different functional brain areas can further assist in predicting the progression of MCI, offering a pivotal basis for diagnosing the disease.	Given the consistency and variations in study findings, further research is imperative to enhance the value of early diagnosis.
DWI	DWI stands as the sole non-invasive magnetic resonance technique capable of detecting the motion of water molecules within living tissues. DTI is utilized to evaluate the integrity of white matter fibers throughout the brain. DKI vividly illustrates changes in tissue microstructure, particularly in deep gray matter nuclei. They are valuable tools for screening MCI and forecasting its progression to dementia.	DWI’s high sensitivity to movement, combined with its lengthy examination and scanning process, can result in skewed outcomes, limiting its clinical utility.
MRS	Metabolic alterations often manifest before structural ones. As a result, MRS has the capacity to identify metabolic anomalies undetectable by conventional MRI, underscoring its significance in the early diagnosis of MCI.	Although MRS allows for noninvasive examination of molecular activities in the brain without subjecting individuals to ionizing radiation, its efficacy is curtailed by its limited sensitivity.
ASL	ASL boasts several key advantages, including the absence of contrast media injections, no radiation exposure, repeatability, brief acquisition time, and uninfluenced performance by the blood-brain barrier. Given these merits, ASL emerges as a potentially cost-effective, safe, and practical alternative to positron emission tomography in clinical research. Its utility is especially evident in detecting and monitoring early vascular perfusion changes associated with MCI.	ASL minimizes individual variations in vascular characteristics. However, these variations can result in changes in signal intensity that clinicians might misinterpret as disease-induced abnormalities. One notable limitation of ASL in clinical application is its low signal-to-noise ratio, resulting in diminished image quality.

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Correspondence: Hongyan Xie; Email: clinicalxhy@163.com.