Volume 8 (will be Vol 7 on site)


The Use of MRI for the Early Prevention of Alzheimer’s Disease
Joy Akindulureni

 Abstract
Alzheimer’s Disease (AD) is a neurodegenerative disorder that affects the cells in the brain which results in dementia. AD is
caused by the accumulation of Amyloid Beta (A𝛽)peptides made from protein forms an accumulation in the brain that leads to
plaques and tangles that affects the medial temporal lobes and neocortical structures. Early detection of AD is very important
for intervention and early treatment to prevent the further progression of the disease in individuals. Magnetic Resonance
Imaging (MRI) is a neuroimaging tool that can be used to help study brain changes. MRI can help to detect biomarkers that are
associated with AD which could be white matter hyperintensities, hippocampal volume loss, and tau phosphorylation. Tau
phosphorylation is due to cerebral atrophy which leads to neurodegeneration. The application of MRI in the early detection of
AD could help in the progressive treatment and preventative methods for individuals who have AD or are at risk of developing
the disease. This paper will discuss the use of neuroimaging, specifically MRI on the early detection of Alzheimer's in people
which can be used in clinical settings and lead to better prevention methods.

Introduction
Alzheimer’s Disease (AD) is characterized by decline in
cognition, memory loss which in turn alters behavior and
interferes with activities of daily living (Breijyeh& Karaman.,
2020). It is more defined as an interaction of amyloid 𝛽eta
protein with glial cells and neurons, which results in neuritic
plaques and neurofibrillary tangles in the cerebral cortex
mostly in the medial temporal lobes and neocortical
structures (Srivastava & Ahmad, 2021). AD is shown by
cognitive decline, language capabilities, and loss of memory
all of which can later affect behavior of the individual. Some
structural symptoms would be progressive loss of neurons,
neuronal network destruction and atrophy of the
hippocampus (Blennow, 2006). AD symptoms are
categorized based on early, moderate or late stages. 

AD is a very complicated disease that could be caused by
very different factors and there is no precise cause of the
disease. For the early stage, the symptoms like
misplacement of items, mood changes and memory loss are
easily dismissed . The moderate stage is when the symptoms
become more severe with difficulty in communication and
spatial navigation which can interfere with personal life. In the
late stage, symptoms are more severe with no remedy like
inability to recognize familiar faces, physical capabilities
(Khan et al., 2020)

Previous studies have also shown that atrophy and volume
loss in the hippocampus are an early characteristics of AD as
they can be associated with cognitive and memory decline
(Eskildsen et al., 2015).Therefore, AD is the leading cause of
dementia in the world; its prevalence continues to increase
with the numbers doubling every 20 years. AD constitutes
challenges for the healthcare system and signifies the need
for strategies that could lead to early detection. 

Early detection of AD is very important for the development of
preventive measures and progressive treatment methods for
individuals at risk. With neuroimaging tools today, MRI and

PET are the most common for their ability to detect brain
abnormalities that could lead to a risk in developing AD
(Mosconi et al., 2007). Witb these neuroimaging tools, we
can be able to further prevent the development of AD in
individuals.

Alzheimer’s Disea se  
AD is a neurodegenerative disorder and a common cause of
dem entia that is caused by cell death due to neuritic plaques
and neurofibrillary tangles in the cerebral cortex. It is the sixth
most leading cause of death in the United States and is
caused by neuronal cell death which starts in the entorhinal
cortex of the hippocampus. AD’s etiology involves the
combination of genetic predisposition, environmental factors
and lifestyle choices. Even though AD is known to affect
people who are older, it is necessary to know that the
symptoms do not progress with age (Zvěřová, M., 2019).
Many studies have shown that aging is associated with AD as
they have been with approximately 90% of the cases. AD
usually affects people from ages 65 and older but it is also
possible that the disorder could show up earlier due to other
factors like genetic mutations or even underlying health risks
like heart diseases or stroke (Blennow., 2006). AD
prevalence has been known to be increasing for each year
and could keep increasing with the amount of cases each
year. 

The biomarkers for AD are mostly with blood and the
structural brain changes due to the neuroimaging tool that is
being used like MRI as it is more accessible and can be
better used for diagnosis of the disease.(Altuna-Azkargorta &
Mendioroz-Iriarte, 2021). Biomarkers are very essential for
the diagnosis of the disease and also help with the use in
treatment methods as well. Pathology of AD stems from the
plaques and tangles in the brain due to tau phosphorylation.
Another biomarker for diagnosing AD could be due to the
lessening of hippocampal volume and hyperintensities of
white matter in the brain (Schapiro et al., 2009). Early
detection of AD would lead to better preventative methods
that can be used in clinical settings for individuals.



The Role of MRI in the Detection of Alzheimer’s
Disease
MRI, an innovative and non-invasive tool plays an important
role in identifying brain changes earlier that are associated
with AD leading to progressive interventions. With MRI,
neurodegeneration which is present in cerebral atrophy can
be captured by MRI imaging. While not being specific to
cerebral atrophy, this biomarker of neurodegeneration along
with neuronal injury serves as an important biomarker in the
diagnosis of AD.

 are also another type of biomarkers that can be used in the
diagnosis of AD. Cerebral atrophy is caused by
neurodegeneration which can be captured by MRI.
Optimization of MRI to diagnose AD can be very valuable in
the early detection of the disease. Progression of the atrophy
is also later seen in the Medial Temporal Lobe (MTL) and
entorhinal cortex which later results in deficits in executive
functioning and memory loss for AD patients. MRI can also
be used to detect white matter hyperintensities which show
demyelination and axonal loss. With the use of MRI, it can
play a huge role in the early detection of the disease which
could lead to better treatment methods for individuals at risk
before it progresses further. 

The focus of the use of MRI can help in detecting the
biomarkers associated with AD. The biomarkers associated
with AD that could be detected would be cerebral atrophy,
which is the loss of neurons and synapses that leads to brain 

shrinkage from neurodegeneration. Atrophy and volume loss
of the hippocampus also show the characteristic of AD that is
associated with cognitive decline. This could spread to other
regions which leads to worse progression of the disease.
When the atrophy spreads to the cortical regions like frontal,
parietal and temporal brain regions, the disease worsens
which can be captured with MRI (Chandra et al., 2018).White
matter hyperintensities is another biomarker that could be
detected by MRI as they show the demyelination and loss of
axons in the brain. The application of MRI in early detection
of AD could make for better treatment methods that can help
individuals with the disease or who could be at risk (Chandra
et al., 2018).

Challenges and Directions
While MRI can be used in the detection of AD, it also faces
limitations due to sensitivity of being able to differentiate AD
from either normal aging or other neurological diseases. This
limitation showcases the importance for research and
refinement. Another limitation would be that there could be an
overlap of the imaging characteristics with other disorders
that could make the results more complex. Another limitation
would be the accessibility and cost that comes with using the
MRI due to the equipment, which could limit its use and
availability in certain settings.

MRI in the early detection of AD can be useful for the
progression of treatment methods of the disease. MRI can be
used to capture the alterations in brain structure like the
hippocampal volume, white matter loss, and atrophy, which
can give a quick insight on the development and progression
of the disease before it worsens. MRI can also help clinicians
and researchers be able to understand better about the brain
structures affected and how they impact function so that there
could be more methods for treatment which might eventually
lead to a decrease in the prevalence.

Conclusion
AD is a neurodegenerative disorder that affects millions of
people worldwide and is known for being associated with
aging as it mostly affects the elderly. It is caused by tangles
and plaques due to tau phosphorylation which leads to
neuronal cell death that affects the cerebral cortex. It is
characterized by memory loss, brain structure atrophy,
language capabilities and behavioral alterations. Although
there is no known cause, there could also be a lot of factors
that contribute to the disease which could be genetic or
environmental. There are no preventive measures but there
are protective measures like maintaining a healthy lifestyle
and being physically active which could help. 

MRI being a non-invasive tool in neuroimaging could play an
important role in the detection of AD that could potentially
lead to the further progress of treatment methods. There are
some limitations and challenges which could come with the
use of the neuroimaging tool like the cost, complexity of the
detecting for the disease, and the overlap in imaging features
although it can still be an innovative tool to be able to detect
for the disease earlier that could lead to better methods for
treatment.

Figure 1. a) Structure of the brain when a healthy with the neurons
and hippocampus with b) Alzheimer’s showing the plaques in

neurons and shrinkage of hippocampus
(Breijyeh& Karaman., 2020)

Figure 2. Increased White Matter Hyperintensities in an Alzheimer’s
patient compared to a healthy normal control and a patient with Mild

Cognitive Impairment (MCI) (Chandra et al., 2018).

Brain Matters・Volume VII      64



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