Dementia is a syndrome characterized by multidomain acquired chronic cognitive impairment that has a profound impact on daily life. Neurogenerative diseases such as Alzheimer's disease or nondegenerative diseases such as vascular dementia are considered to cause dementia. The need for further diagnostic improvement originates from the prevalence of these conditions, especially in developed countries with a predominance of the elderly population. Today, the diagnosis and follow-up of all neurodegenerative diseases cannot be performed without radiological imaging, primarily magnetic resonance imaging (MRI). The introduction of 3T MRI and its modern techniques, such as arterial spin labeling, has enabled better visualization of morphologic changes in dementia. For better diagnosis and follow-up in patients with dementia, various semiquantitative scales have been designed to improve the accuracy of assessment and decrease interobserver variability. Moreover, there is a growing need for MRI in the assessment of novel therapies and their side effects. To better apply MRI findings in the diagnosis of both already developed dementia and its early stages, the aim of this paper is to review the available literature and summarize the specific MRI changes.

This study investigated the diagnostic accuracy of plasma biomarkers—specifically, matrix metalloproteinase (MMP-9), tissue inhibitor of metalloproteinase (TIMP-1), CD147, and the MMP-/TIMP-1 ratio in patients with Alzheimer’s disease (AD) dementia. The research cohort comprised patients diagnosed with probable AD dementia and a control group of cognitively unimpaired (CU) individuals. Neuroradiological assessments included brain magnetic resonance imaging (MRI) following dementia protocols, with subsequent volumetric analysis. Additionally, cerebrospinal fluid (CSF) AD biomarkers were classified using the A/T/N system, and apolipoprotein E (APOE) ε4 carrier status was determined. Findings revealed elevated plasma levels of MMP-9 and TIMP-1 in AD dementia patients compared to CU individuals. Receiver operating characteristic (ROC) curve analysis demonstrated significant differences in the areas under the curve (AUC) for MMP-9 (p < 0.001) and TIMP-1 (p < 0.001). Notably, plasma TIMP-1 levels were significantly lower in APOE ε4+ patients than in APOE ε4− patients (p = 0.041). Furthermore, APOE ε4+ patients exhibited reduced hippocampal volume, particularly in total, right, and left hippocampal measurements. TIMP-1 levels exhibited a positive correlation, while the MMP-9/TIMP-1 ratio showed a negative correlation with hippocampal volume parameters. This study sheds light on the potential use of TIMP-1 as a diagnostic marker and its association with hippocampal changes in AD.

Background/Objectives: Acute ischemic stroke (AIS) is one of the leading causes of mortality worldwide and the primary cause of acquired neurological disability in adults. As part of a stroke magnetic resonance (MR) protocol, fluid-attenuated inversion recovery (FLAIR) plays an important role in the detection and assessment of the degree of leukoaraiosis (LA), while susceptibility-weighted angiography (SWAN) detects cerebral microbleeds (CMBs). The present study sought to examine the association of the degree of LA and CMBs with absolute cerebral blood flow (aCBF) values and functional outcome prediction in patients with AIS. Methods: We conducted a cross-sectional study including a total of 205 male and female patients. All of the patients underwent brain magnetic resonance imaging (MRI) examinations in the first 24 h following suspected AIS, using the stroke protocol. A modified Rankin scale (mRS) was used to evaluate the degree of functional dependence and disability three months after AIS. Results: The incidence of an unfavorable functional outcome evidently increased with more pronounced LA modalities (p < 0.05; χ² test). The Kruskal–Wallis test found a statistically significant difference in aCBF values in relation to a degree of LA (p < 0.05). As there were a small number of multiple CMBs, no statistically significant difference was found based on the detection and degree of CMBs with aCBF and functional outcome; hence, the hypothesis was not entirely confirmed. Conclusions: This study indicates the reliability of MRI application in the initial diagnostic evaluation in order to gain an additional insight into the prediction of AIS outcomes. We demonstrated that LA correlates significantly with an unfavorable functional outcome after AIS, with decreased perfusion values. On the other hand, a higher proportion of unfavorable functional outcomes was observed in patients with CMBs. However, this result was not statistically significant and should be interpreted with caution.

Although genetic variations rs780094 and rs1260326 of the glucokinase regulatory protein gene (GCKR) could be associated with lipid profile imbalance, their influence on acute ischemic stroke (AIS) risk has not yet been established. The aim of this study was to investigate the influence of GCKR single nucleotide polymorphisms (SNPs) rs780094 and rs1260326 on lipid profile parameters in patients with AIS, and to evaluate the association of these SNPs with the risk of AIS. In a case-control study, a total of 148 subjects were screened for GCKR rs780094 and rs1260326 SNPs using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The lipid profile was determined based on serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triacylglycerol (TG) concentrations. The frequencies of the minor rs780094T allele and the minor rs1260326T allele were significantly lower in AIS patients compared to controls. The rs780094TT genotype and the rs1260326TT genotype were associated with decreased risk of AIS compared to wildtype carriers. In conclusion, this is the first study implying that decreased risk of AIS in rs780094 and rs1260326 homozygous minor allele carriers is not caused by dyslipidemia, but possibly by the lack of coagulation factor glycosylation.

Alzheimer's disease (AD) is characterized by a heterogeneous clinical course, and magnetic resonance imaging (MRI)-based phenotyping has increasingly been utilized to elucidate this variability. The literature recognizes four predominant MRI phenotypes: typical, hippocampal-sparing, limbic-predominant, and minimal-atrophy. However, the compatibility of various MRI phenotyping methods remains insufficiently defined. This study aimed to assess the concordance between MRI phenotyping methods within a Serbian cohort consisting of 40 subjects. Four MRI phenotyping approaches were employed: scale-based, adjusted scale-based, volume-based, and thickness-based. The scale-based method exhibited moderate agreement with the adjusted scale-based approach and high concordance with volumetric methods. In contrast, the relationship between scale- and thickness-based phenotyping was less clear. The lack of significant agreement with demographic variables, along with the observed differences across clinical dementia rating (CDR) domains, further underscored the clinical heterogeneity among phenotypes. Overall, these findings suggest that visual scale-based MRI phenotyping may serve as a practical approach in resource-limited clinical settings where advanced methods are unavailable. However, the results must be interpreted with caution and require validation in larger independent cohorts. Further research is necessary to clarify the relationship between scale- and thickness-based phenotyping across different disease stages and to investigate discrepancies in demographic, apolipoprotein E (APOE)-related, and clinical phenotype patterns in this Serbian sample compared to other populations.