As prevalent as dementia is among elderly people, the early signs are usually hard to detect. It’s not until the patient has progressed into the later stages of the disease that those around them notice it. This is why brain scans are important for physicians to diagnose dementia in its early stages.
Dr. Jose Pizarro of Longboat Key, Florida, is board certified in diagnostic radiology and neuroradiology. He is the former chairman of radiology and section chief of neuroradiology at Mount Sinai Medical Center. Jose Pizarro MD has worked together with several leaders and researchers in the field of Alzheimer’s disease, memory disorders, and diffusion tensor imaging. He currently evaluates diffusion tensor Imaging and the effects of trauma on thousands of patients every year, including many NFL players.
What is Dementia?
As we age, it becomes difficult for us to remember things. Birth dates, certain memories, or even what we had for breakfast. However, in most cases, these slight lapses of memory don’t affect an elderly person’s daily life. Senior citizens can have a perfectly normal life even if they occasionally misplace their car keys or the TV remote control. But when memory loss becomes a serious problem, that’s when the doctor might suspect the onset of dementia.
According to Dr. Jose Pizarro, dementia doesn’t just involve frequent memory lapses but also the loss of normal skills. With time, the patient finds it harder to think and make even simple plans. And while it might take some patients years for dementia to progress, others could see a rapid decline in their memory and brain functions in a short time.
While not every elderly person will get dementia, early detection is important to help people with dementia slow its progress. Physicians perform different tests, including blood tests, to make sure the symptoms are not caused by other conditions such as kidney, liver, or thyroid diseases. But when memory and blood tests don’t give conclusive answers, the doctor will turn to brain scans along with other assessment procedures to diagnose dementia.
Since dementia causes shrinkage in certain parts of the brain, a magnetic resonance imaging (MRI) scan can help the physician detect that shrinkage. Radiologist Jose Pizarro MD points out that if the shrinkage occurs in both the temporal and frontal lobes, that indicates frontotemporal dementia. However, he adds, in the case of Alzheimer’s disease, the patient suffers shrinkage only in the temporal lobe.
MRI can also detect the symptoms and causes of vascular dementia. This type of dementia affects the blood flow to the brain. So, with an MRI scan, the radiologist can assess any damage to the blood vessels and look into other health conditions such as high blood pressure, tumors, and strokes. MRI scans use magnetic fields along with a computer to create an accurate image of the brain.
Unlike an MRI scan, a computed tomographic scan, CT scan for short, doesn’t give a detailed diagnosis of the deterioration in the brain or its structure. CT scans use X-ray technology to look for signs of tumor, ischemia, brain atrophy, or strokes. This in effect exposes the patient to certain amounts of radiation, making CT scans less safe than MRI scans. The whole test; however, doesn’t take long and can be done during a short visit to the hospital.
PET and SPECT Scans
According to Dr. Jose Pizarro, if neither of the above two scans detects the signs and causes of dementia, the physician would recommend a positron emission tomography (PET) or a single-photon emission computed tomography (SPECT) scan. They both give a more detailed look into how the brain is functioning. The radiologist will monitor the blood flow in the brain and detect any abnormalities in brain functionality as a result of changes in oxygen or glucose metabolism. PET scans can also pick up the presence of amyloid proteins which disrupt the tissue architecture, and consequently the functionality, of the brain.
Other types of brain scans, such as EEG, monitor and record the electrical activity in the brain if either seizure or epilepsy is the suspected cause of dementia.