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Neuroimaging approach of atypical forms of Alzheimer's disease

      Alzheimer's disease (AD) is not a unitary clinical syndrome. Patients with early age-of-onset AD can present with multi-domain cognitive impairment at onset. This cognitive picture is very different from the typical profile of late-onset patients with progressive memory deficit as the central feature. AD can also present as atypical, relatively focal clinical syndromes, more frequently associated with early age-of-onset, i.e., as posterior cortical atrophy (PCA) and logopenic variant of primary progressive aphasia (lvPPA). Neuroimaging, including magnetic resonance imaging (MRI) and positron emission tomography (PET), is playing an increasingly important role in the study of atypical forms of AD, delineating the structural and functional brain alterations associated with these conditions. Neuroimaging patterns acquired at the prodromal stage can discriminate between AD and other neurodegenerative diseases and among AD variants. Advanced MRI techniques are of special interest for their potential to characterize the signature of each neurodegenerative condition and aid both the diagnostic process and the monitoring of disease progression. All these findings will become crucial when disease-modifying (personalized) therapies will be established.
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