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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