In 2023, the FDA approved the first in a series of Alzheimer’s therapy known as anti-amyloid treatments to slow the progressive decline of common cognitive functions, including memory and thinking processes, offering new hope for patients and their families to maintain the quality of life in early stages of the disease.
Medical imaging has always played an important part in Neurology, a branch of medicine that focuses on the diagnosis, treatment, and study of disorders affecting the brain and other structures of the nervous system, by providing neurologists a look at one of our most vital organs. Medical imaging also plays a crucial role in the treatment therapies.
As a national leader in outpatient imaging, Touchstone Medical Imaging developed the Alzheimer’s Imaging Center of Excellence to provide patients, their families, and neurologists with a convenient and cost-effective medical imaging resource for diagnosing and monitoring progress during anti-amyloid treatments.
What is Alzheimer’s Disease?
Alzheimer’s disease is a complex neurodegenerative disorder and a form of dementia characterized by progressive cognitive decline and memory loss. The exact cause of Alzheimer’s is not fully understood, but it is believed to result from a combination of genetic, environmental, and lifestyle factors.
What are Amyloid Plaques in the brain?
Amyloid plaques are abnormal clumps of protein fragments that accumulate between nerve cells (neurons) in the brain. They are one of the hallmark features of Alzheimer’s disease. Here’s a more detailed explanation:
Composition:
- Amyloid plaques are primarily composed of beta-amyloid, a protein fragment derived from the amyloid precursor protein (APP). APP is a normal protein found in the fatty membrane surrounding nerve cells.
Formation:
- Under normal circumstances, APP is broken down and eliminated by the body. However, in Alzheimer’s disease, the breakdown process goes awry, leading to the production of beta-amyloid fragments that stick together to form plaques.
- These beta-amyloid fragments are sticky and tend to accumulate and clump together, forming plaques.
Location:
- Amyloid plaques accumulate in the spaces between neurons. They are often found in regions of the brain involved in memory and cognitive function, such as the hippocampus and cerebral cortex.
Impact on Brain Function:
- The presence of amyloid plaques disrupts communication between neurons and triggers an inflammatory response in the brain.
- This inflammation, along with the toxic effects of the plaques themselves, contributes to the death of neurons and the loss of synapses (the connections between neurons), which are critical for learning and memory.
- Over time, this neuronal loss leads to the progressive cognitive decline characteristic of Alzheimer’s disease.
What do Anti-Amyloid Therapies Do?
Anti-amyloid treatments work by addressing the condition on a biological level by removing beta-amyloid, a protein that accumulates into plaques, from the brain. As with most biological treatments, side effects are a possibility and monitoring these effects on the brain’s structure is done through MRI imaging.
Why is Medical Imaging Important for Alzheimer’s Anti-Amyloid Treatment?
Medical imaging plays a part in both the diagnostic and side-effect monitoring of anti-amyloid treatment.
Medical Imaging’s Role in Diagnosis
Before treatment can begin, a patient must first be diagnosed with Alzheimer’s. Neurologists and insurance companies primarily rely on medical imaging techniques to verify the presence of beta-amyloid in the brain. PET scans and MRI scans are two medical imaging technologies used to visually determining the presence of beta-amyloid.
The PET scan is often seen is a lost effective and comprehensive medical imaging option for identifying beta-amyloid. PET scan can show beta-amyloid plaques in the brain through the use of specialized radioactive tracers that bind to beta-amyloid deposits that can then be visualized on the PET scan image. A sub-specialized neuroradiologists or nuclear medicine radiologist reviews the images and analyzes the presence of beta-amyloid.
MRI imaging may also be used to identify the presence beta-amyloid with a specializing imaging technique. The type of diagnostic imaging scan to be performed is determined in collaboration with the neurologist.
Medical Imaging’s Role in Anti-Amyloid Treatment Monitoring
ARIA is one of the most common side effects of anti-amyloid treatment. ARIA may be present in two forms in the brain:
- A temporary swelling in areas of the brain.
- Small spots of bleeding in or on the surface of the brain.
Neurologists and therapy manufacturers rely on MRI imaging at regular intervals during the treatment process to assess the brain determining if the ARIA side-effects are present during treatment and to what extent. The presence and severity of ARIA may determine if the patient may continue the treatment therapy.
What is Touchstone’s Alzheimer’s Imaging Center of Excellence?
Touchstone Medical Imaging specializes in providing access to state-of-the art imaging services in an outpatient setting, including PET and MRI scans, that are cost-effective and convenient for patients and healthcare providers.
Touchstone Medical Imaging has over 60 outpatient imaging centers in six states. Many of the centers offer morning, evening and weekend hours providing access to patients outside of the typical 9-5 schedule. With in-network status with 99% of major health insurance plans, Touchstone provides a convenient option for patients to obtain the necessary imaging scans before and during anti-amyloid treatment without the cost or inconvenience of going to a hospital.
Touchstone Imaging also partners with leading board-certified, subspecializing radiologists to interpret imaging scans and provide the diagnostic insights healthcare providers need to determine next steps in care. Brain MRI scans are evaluated by neuroradiologists who specialized in reading and evaluating brain imaging studies. These neuroradiologists are trained in evaluating anti-amyloid treatment monitoring MRIs and assessing for presence and severity of ARIA side effects that help a neurologist determine if it is safe for a patient to continue with their treatment therapy.
Touchstone Alzheimer’s Imaging Center of Excellence are now available in Denver, Colorado; Dallas-Fort Worth, Texas; Austin, Texas; Oklahoma City, Oklahoma; and Pensacola, Florida.
