Hi--I took my DH to a neurologist who was highly recommended. I sent some notes ahead of time, detailing memory losses I'd seen, as well as other incidents that had shown up over the years, ie, aggression, rages, disorientation. DH is 78; I am 68. Twenty year second marriage. At the first appointment with the neurologist, based on talking with DH (I was in the room), and based on my previous notes to the doctor, he told him that he has vascular dementia. He ordered an MRI. Prior to our appointment to discuss the MRI results, which the doctor hadn't seen yet, I ran into the doctor in his office and he told me that DH also has frontotemporal dementia, in addition to the VD. A few days later we went into his office to discuss the MRI results. The doctor said the MRI was clear, that it showed nothing. So he then said DH has mild cognitive impairment, and not VD or FTD.
Can the MRI show nothing, in spite of obvious memory/behavior problems?
PS: In the car on the way home, DH turned to me and spit out, "Maybe YOU need to get YOUR memory checked!!"
Yes sometimes it takes more than 1 mri. It helps if they have something to compare it to. My husband was diagnosed in Dec. 2006 with FTD. That was after his 3rd MRI inabout 3-4 years. Just watch and wait. If you see any significant changes go back to nuerologist. This is a very hard disease to diagnose. It has been said that a definitive diagnosis can be only be made through an autopsy. Keep hanging in there.
Yes, I DO believe that there is still a problem also. DH got very angry with me as he began to put two and two together that I was the one behind his having to go to this neurologist. We had two very bad fights over this. He couldn't have been uglier. He said he was moving out, and I told him to go ahead. Next time I'm going to take him up on it. I'm so tired of having to deal with his ugly behavior towards me.
My husband has had 5 MRI over the last 8 years. The last was a year ago, showed no more shrinkage than for what was normal for a 56 year old man. He diffently has dementia, just not positive it is Alzheimer's He just had a PET Scan on July 25th, we haven't received the results yet.
My husband also had a MRI that just showed normal aging of the brain. He is in the moderate stage of AD. The diagnosis was made after the mini mental test.
Generally, the MRI is done to rule out strokes and tumors, so if there is none of that, they start looking at types of dementia. The PET Scans are usually the ones that can determine brain shrinkage.
MRI, CAT (also called C-T), and PET scans are all imaging techniques. However, they provide different types of information. While an MRI or CAT scan shows the structure of the brain, a PET scan shows how the brain functions.
The first imaging test that is done is typically an MRI, although sometimes a CAT scan is used instead. (MRI provides better images of intracranial structures, especially cerebral white matter, and is more sensitive at picking up vascular lesions than CAT. However, MRI cannot be used when a patient has a cardiac pacemaker or metallic intracranial aneurysm clips.) An MRI will show atrophy (shrinkage), tumors, or lesions from cerebrovascular disease (indicating vascular dementia), and can sometimes be used to help diagnose FTD if it shows asymmetrical knife-edge focal atrophy of frontal and/or temporal areas.
PET measures cerebral metabolic activity (using radioactively-labeled glucose) and can compare cerebral metabolism, blood flow and receptors in different regions of the brain. This can be helpful in confirming Alzheimer's, especially in patients whose MRIs do not show cerebrovascular disease or asymmetrical atrophy (shrinkage).
My husband was diagnosed with moderate AD. His MRI showed an abnormal degree of shrinkage for a man of his age, but no sign of vascular lesions. (He has had one TIA that we know of, but presumably too small to show up on film.) The PET showed abnormal glucose metabolism in a pattern typically associated with AD.
In answer to your specific question, Hanging On, if your husband is in the earlier stages of AD, VaD, or FTD, then yes, an MRI can be "clear". I would think it would be particularly hard to detect mild atrophy if there were no earlier MRIs for comparison.
"Perfectly normal" MRI here too, yet obvious decline. In the BAP study MRI's are done every 3 months so surely they must feel that some changes can be seen. This is very puzzling.
My husband's CAT scan did show some damage which is why they said vascular dementia. It was a CAT scan because of his pacemaker. We never went any further with tests. His dementia from that practices' mini-mental was obvious(they don't do the actual test, but have asked every question on that test and others from other tests as well).
They do the CAT to see if there is something that can be fixed. It is part of the rule out all other diseases before we say it is dementia because we can treat other diseases. That is the reason for the blood tests too. They can treat low thyroid disease, for example. And if it is bad enough, and not being medicated, the fog can be pretty bad.
....uh, Inge, they may be doing the MRI's to watch out for severe side effects from the drug, especially encephalitis (brain inflammation, an autoimmune disease effect of the inoculation.) Clinical trials on an earlier approach for treating AD had to be stopped when 6% of the patients developed encephalitis. The new approach is based on a different mechanism that is supposed to avoid this type of complication, but they still need to be ultra-careful.
Dazed, my father was a doctor and he talked about his work all the time I was growing up. Spent a lot of time in hospitals when various of my loved ones were sick. My older sister was a PhD, studied nerves in snails. (She was a riot when we went to dinner at fancy restaurants, dissecting the escargot...) I'm a techie, a little of this, a little of that, detection of pathogens, using bacteria to develop new catalysts, using proteins for all sorts of things, and most recently working on developing tools that can be used in drug discovery and development.
Wow, Sunshyne, having absolutely no medical background or knowledge myself, I am really impressed! I've noticed that if you don't know about something, you research it for us or have your sister look into it. Thanks.
Actually, I do all the googling -- I do a lot of online researching to keep up with advances in the fields that interest me, and to prepare for writing grant applications. I enjoy it ... so fascinating. My sister died of Crohn's 23 years ago, after battling the disease for many years. She never had a chance to do much with her degree. Very sad, she was quite gifted in art and music as well as science. (It was a REAL pain following three years behind her in grade school and high school, having many of the same teachers. "Oh, my, you're not very much like your sister, are you..." But then, the person who really deserved pity was my poor younger sister, trailing along behind the two of us! She majored in math instead.)
Thank you for that Sunshyne. I knew of those complications in earlier trials but took it on good faith that these no longer happen. I will definitely be asking more questions of the doctor.
Thank you all for your helpful comments. I had thought that DH still has something going on, even though the MRI didn't show anything. It helps to hear that many others have had MRI's that were ok, yet there was still something there.
He's so hard to deal with that I am going to sit back and wait to see what happens. It didn't work out well, my going behind his back to his primary doctor, and then to the neurologist, to try to get some answers for his behavior. He got very upset that we ended up at the neurologist, and took it out on me. We got very close to divorce, and still are. So I will try to talk with him directly if he gets any worse.
Hanging On there are many members here who have been or are where you are now. with an undiagnosed spouse who has AD symptoms but refuses to see a dr or take any med to control their behaviour. if they are in denial its walking on eggshells to get something done to help your situation. maybe others who are going thru this with their spouses will add more, -hope you find a way, divvi
As I posted "Under Results of the PET Scan, my husband has been diagnosed with FTD this is after 5 MRI, Lumbar Puncture, EEG's, Numerous Blood Test & 2 PET Scans. He has been having problems for about 8 years, the last 5 years with memory declining every year. Some of the MRI were looking for causes for the Absence Seizures that started this journey into Hell.
Ok - I learned something tonight. When I saw the first posting with VD, I became a little alarmed and said to myself that I didn't know that veneral disease was part of cognitive functioning,disorder process. However, as I read on, I was able to breathe a sigh of relief when it was noted that it meant Vascular Dementia.
Now I am stumped again. Kadee, you mention "Absence Seizures". I have never heard of that. Will that scare me too :-)
Thanks I have printed it to show it to my husband. I know this has been happening to him but he denies it - he can't remember it. I am concerned with driving and these episodes.