Multimodal magnetic resonance scans of patients with mild cognitive impairment

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

doi:10.1590/1980-5764-DN-2023-0017

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Dementia & Neuropsychologia

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

Multimodal magnetic resonance scans of patients with mild cognitive impairment

Ressonância magnética multimodal de pacientes com comprometimento cognitivo leve

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The advancement of neuroimaging technology offers a pivotal reference for the early detection of mild cognitive impairment (MCI), a significant area of focus in contemporary cognitive function research. Structural MRI scans present visual and quantitative manifestations of alterations in brain tissue, whereas functional MRI scans depict the metabolic and functional state of brain tissues from diverse perspectives. As various magnetic resonance techniques possess both strengths and constraints, this review examines the methodologies and outcomes of multimodal magnetic resonance technology in MCI diagnosis, laying the groundwork for subsequent diagnostic and therapeutic interventions for MCI.

Keywords:
Magnetic Resonance Imaging; Cognitive Dysfunction; Early Diagnosis

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.