MRI in the Clinical Management of Alzheimer’s Disease: from Early Detection To Therapy Guidance

Abstract Purpose of Review Neuroimaging, in particular magnetic resonance, has become a pivotal tool in understanding the pathophysiology of dementia, including Alzheimer’s disease (AD) and non-Alzheimer’s dementias (NAD). Combining structural and functional imaging techniques enables us to identify early brain changes, improve differential diagnosis, and monitor disease progression. This review focuses on the role of magnetic resonance imaging (MRI), especially functional MRI (fMRI), in supporting the clinical diagnosis of AD and distinguishing it from other forms of dementia. Recent Findings Advances in imaging techniques, such as structural MRI and fMRI, have significantly improved our ability to visualize pathological alterations associated with neurodegenerative conditions. While neuroimaging alone cannot provide a definitive diagnosis, it is a fundamental tool for clinicians in managing dementia, particularly in the early stages when clinical manifestations may be minimal or non-specific. MRI also plays a key role in monitoring responses to and side effects of therapies. Summary Our work has focused on evaluating the role of functional MRI in the study of Alzheimer’s disease, particularly in supporting the clinical diagnosis process and differential diagnosis with other types of dementia, as well as how MRI helps to monitor the response to new therapies for Alzheimer’s disease, such as anti-amyloid monoclonal antibodies.