The Metabolic Cerebral Imaging in Incipient Dementia study

By Chris Berry

The Metabolic Cerebral Imaging in Incipient Dementia study is an ongoing nationwide clinical study sponsored by the Centers for Medicare and Medicaid Services (CMS). Data revealed that patients with doctors who gleaned information from a brain PET scan fared better over a two-year-period than those whose doctors were randomized to not have access to the scan information.

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“The patients whose doctors were made aware of the Alzheimer’s Disease metabolic pattern in their brains received Alzheimer’s therapies sooner, and did better than patients whose doctors did not have the benefit of that information,” said study principal investigator Daniel Silverman, a UCLA professor of molecular and medical pharmacology. “During the subsequent two years after their PET scans, these patients had superior executive function, better memory abilities and greater preservation of overall cognitive function, providing the first direct evidence that patients whose early Alzheimer’s disease is revealed by FDG-PET will do better than patients with the same condition, but with their brain metabolism pattern remaining unknown to their doctors and themselves.”

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Findings from the study are being presented Sept. 26 at the Medical Biotech Forum in China. Currently, Medicare does not reimburse for PET scans for patients showing signs of an active cognitive decline, but who do not yet have dementia, Silverman said.

Medicare is reexamining policies for PET scans in dementia cases. A national coverage decision is expected Oct. 1. There has been no previous controlled scientific evidence available that tested the long-term clinical benefit as a result of a PET scan, or any other neuroimaging when evaluating cognitively declining patients.

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This study has revealed major clinical benefit with the potential to save healthcare dollars.

“Patients who don’t have Alzheimer’s disease may be prescribed drugs that won’t help them, or even make them worse,” Silverman said. “And each year of taking these medications costs hundreds of dollars more than the reimbursement for a PET scan would.”

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