Why Do Some People with Alzheimer's Pathology Develop Symptoms, While Others Do Not — and How Should That Affect Treatment?
For Neurology Today’s “Best Advances of 2013,” David Gill, MD, an editorial advisory board member, selected a Neurology study that looked at autopsies of subjects with and without symptoms of Alzheimer’s disease (AD) who had varying degrees of AD neuropathologic changes. Among the findings, expression of AD symptoms was affected more by neurofibrillary tangle scores than neuritic plaque burden, and symptomatic patients tended to be older, have a history of recent depression, and have higher Hachinski Ischemic Scores, suggestive of vascular dementia (although cerebrovascular pathology was not associated with symptoms). Editor-in-Chief Steven P. Ringel, MD, and Dr. Gill discuss the unanswered questions raised by these findings, including: Is amyloid imaging a good idea for patients at this point? If amyloid is found in the brain, does that mean the patient will develop Alzheimer’s disease? Are PET scans and spinal taps more or less accurate than clinical acumen? See the full “Best Advances of 2013: Picks from the Neurology Today Editorial Advisory Board” article in our Dec. 19 issue: http://bit.ly/IYORLE.