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Psychiatric Times. Vol. 24 No. 4
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Cognitive Impairment: Improved PET Scans Show Plaques and Tangles

Richard Sherer
April 1, 2007

Gary W. Small, MD, professor of psychiatry and biobehavioral sciences and director of the University of California, Los Angeles (UCLA) Center on Aging, headed the team that conducted the research. He and his associates have been investigating the use of PET scans in the diagnosis of AD and related conditions for 6 years.

"Our intention has been to identify a technology that would help us get a measure of plaques and tangles in living people," he told Psychiatric Times. "Whether they cause it or not, they do correlate with the cognitive decline. For that reason, we thought it would be useful to have that technology.

"We came up with the approach of using PET scans, which UCLA patented and licensed to Siemens Medical. It's all been done with NIH funds, not private companies'."

For this phase of their research, Small said, "We screened a number of people with mild to more severe memory complaints. We tried to only include 3 groups of subjects: people with AD, people with mild cognitive impairment, and people with normal age-related mild memory complaints. All of the subjects were classified without brain scans (except for an MRI showing evidence of a stroke or a tumor). We gave them all a new PET scan and then did a more conventional PET scan. We used the MRI scans to draw the regions of interest and to look at regional atrophy.

"The scans did a pretty good job of classifying the clinical diagnosis. The new scan did the best."

Small believes the diagnostic tools his team has developed will pave the way for better management of AD and accumularelated conditions.

"The question of how valuable these findings are has always been raised, especially when we started doing this research," Small said. "We'd say we can find brain abnormalities years before people have AD and the critics would respond with ‘why bother?'That's what is always on people's minds. They don't want to do tests or procedures unless we can do something with the information they provide.

Potential for early treatment
"Now we are at the point of developing new treatments to prevent the build-up of plaques and tangles, and we've got a tool to monitor the effectiveness of these kinds of treatments.

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