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Alzheimer's Disease Neuroimaging

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I'm Dr.Michael Weiner I'm the principal investigator of the Alzheimer's Disease Neuroimaging Iniative, which we call ADNI ADNI is the largest project aimed at understanding the progression from normal aging, to mild memory problems to Alzheimer's disease. It involves more than 1000 subjects who are recruited at 57 sites throughout the USA and Canada. The subjects include completely normal, healthy people, patients with mild memory problems, we call mild cognitive impairment and patients with dementia due to Alzheimer's disease. What we want to show you in this video is the various steps that ocur as a subject goes through the ADNI project. I'm participating in the project myself because I want because I want to assure you that it's an enjoyable project to be involved with, and that the risks are extremely low. When a subject becomes part of this study, there are a series of steps or procedures which they would undergo. The first, and you could argue the most important is the consenting process. In the consenting process, the subject is explained the study fully. They're told everything that's going to be done, and how long things will take. They're explained all of the various risks, although the risks are not very serious, but there some minor risks associated. They are explained the benefits, and in the end the subject has to sign what we call informed consent, which permits the scientist to do these procedures Once we have informed consent, then the subject is asked a wide variety of questions, some relate to simple things, like age and gender and family history of Alzheimer's disease. Others might involve daily activities, or questions about memory and various functions. Questions about mood, are you happy are you sad ? are you depressed ? So, in other words, we want to have a complete picture of each individual and what their capabilities are what their past history is, and what their education is, for example. Then we draw blood, because we use a blood test for a wide variety of measurments. Another we get here in ADNI, is we get genetic information, we take your DNA, and analyze it and measure the various genes, and the purpose of this is to see to what extent genetic risk participates in the development of Alzheimer's disease. Then we do the lumbar puncture, the purpose of the lumbar puncture is to obtain information on the chemicals that are surrounding the brain, because there is a layer of fluid that surrounds the brain. And this fluid has chemicals in it which relate to Alzheimer's disease. The only way we can obtain these chemical is by doing a lumbar puncture in which a needle is inserted and draws out the cervical spinal fluid There is a little kind of a pin prick when they put the Novacaine back there, under the skin and after that you really don't feel a thing. And I'm always a little surprised when they tell me its over, because I didn't realize that they'd really even done it We do MRI scans, and PET scans of the brain to measure changes that occur in the brain during this progression from neural aging to Alzheimer's disease MRI means magnetic resonance imaging, so the imaging is an image of the brain the magnetic is the MRI machine which consists of a very big magnet The beauty of MRI is that its completely non-invasive It does not use x-rays, it does not use anything hazardous But, it's a scanner, that is you go into the scan room, after you've been screened for metal, and they lie you down on this table and it's reasonably comfortable, with a pillow and, after you're properly positioned, you go inside the magnet, and you lie there for a while I usually go to sleep at that point, and the procedure is not that long for this study It's probably about half an hour or 45 minutes time goes by quickly and then they they put you out, and you're done. PET stands for Positron Emission Tomography It's a different kind of scanning than MRI In PET scanning we inject a radioactive compound into the vein, and then, there is a scan of the radioactivity It's radioactive sugar that is injected, and we get a picture of where the sugar in the brain is being taken up A healthy brain takes up a lot of sugar If the brain is diseased, especially by Alzheimer's disease, it takes up less sugar. So we can see a pattern in the brain where there is reduced sugar uptake and that gives us information about the progression of Alzheimer's disease With amyloid PET scanning the radioactivity sticks to the amyloid, so we have a scan of the amount of amyloid in the brain. Some people think that amyloid is a causative factor in Alzheimer's disease. That's still being worked on. But we know it's a marker of Alzheimer's disease. The amount of radiation you get from this PET scan is very small when you compare it to the amount of radiation that we get just on a daily basis We use neuro-psychological tests to measure the ability of people to think. There are all kinds of thinking: there's mathematical thinking there's language thinking there's musical thinking, there's problem solving ... And we have a variety of neuro-psychological tests that people take to remember different things, solve some problems, draw pictures, do things quickly, and all of these tests are a measure of how well the brain is working. Some tests appear to be quite difficult, and people can feel frustrated. But they're purposely difficult, I find some of these tests incredibly difficult to perform and I think my brain is working OK The specific value to you is that any significant medical condition that might be detected would be reported to your doctor, and to you. Sometimes we find things hat can be corrected, and they weren't picked up in the routine medical exams. It's completely private, it's between the patient and the study, so all the information is completely confidential and there is just no way that information from this study would affect future insurance coverage or future mecial care We just want to emphasize that the entire procedure is of extremely low risk We're interested in people who are completely normal and healthy. People who have mild memory problems, or what's called mild cogntive impairment, and people who have been diagnosed with Alzheimer's disease. So the whole range of people over the age of 55 is considered in this study. We need to find ways of treating Alzheimer's disease effectively and ultimately preventing Alzheimer's disease. It would be great for society if we could prevent it, because then as people got older they could enjoy their old age This project is a very important step towards developing improved diagnostic methods and most important to develop effective treatments

Video Details

Duration: 8 minutes and 54 seconds
Country: United States
Language: English
Views: 47
Posted by: zekelhealthcare on Nov 25, 2012

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