Volumetric MRI --- Can anyone offer a speedy explanation

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IzzysDaddy
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Volumetric MRI --- Can anyone offer a speedy explanation

Post by IzzysDaddy »

Hi Everyone,

First time poster. Last week we got the first set of results from a vMRI. The Dr who ordered the test is gone for the next few weeks. When I started to search some of the terms in the report this website had the clearest explanation of some of the terms. We are trying to get a grasp of what these values are and what they represent. It seems that many of the posters on this forum are on top of their own diagnosis, and might be the best way to get some real world opinions from people with experience as to what the vMRI results represent. If this is the wrong type of question to ask, apologies. But as most of you know getting a straight answer to alot of question involving the brain is tough.

Last week they sent the first half of the vMRI report which showed General Cerebral Atrophy to the 14th percentile... That didn't seem like a good result.

Today we got the Neuroreader report... And the values don't seem like good news either. ( I have attached the key pages of it as well).

The office sent a fax copy of the report. We are trying to get a color version of the scans, hopefully tomorrow.

Thank you in advance for taking the time to help teach, share and prepare.


Izzy's Daddy
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mike
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Re: Volumetric MRI --- Can anyone offer a speedy explanation

Post by mike »

IzzysDaddy wrote:Hi Everyone,

First time poster. Last week we got the first set of results from a vMRI.
Welcome to the forum. Sounds like you are Izzy, and the test is for your dad? I'm not very knowledgeable about these tests, so will wait for someone else to comment, but it would likely be helpful to know more about your dad. Do you know his ApoE genotype? How about age and general health condition. What is his cognitive condition - has he had other tests? What kind of diet?
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Re: Volumetric MRI --- Can anyone offer a speedy explanation

Post by IzzysDaddy »

Mike,

Thank you for answering -

50 year old male.

At age 30 have viral encephalitis.

Started having cognitive and memory issues 2+ years ago.

ApoE - DNA sample was taken last week same day as the vMRI.

As for health condition - Overweight, active lifestyle, no smoking, no drinking, no non-prescription drug use ever, super social, super smart (still). Cognitive testing over the past 15 months - Either in the 90%+ percentile or at 1% - Almost nothing in the middle. And on multiple CNS tests has scored 99% in multiple areas (as recently as past 3 weeks)

Diet is lots of meat, no vegetables, but almost no fried or greasy foods. Cholesterol levels are usually on the low side (been tested regularly for past 10 years). Blood Sugar is on the high side of norm - considered pre-diabetic.

Does that help ?
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Re: Volumetric MRI --- Can anyone offer a speedy explanation

Post by mike »

IzzysDaddy wrote:Mike, Does that help ?
Izzy, it should. Do you have any history of Dementia / Alzheimer's in your family? 50 is very young for normal Alzheimer's. It could be that the viral encephalitis may have caused (is causing still?) damage to his Blood Brain Barrier, which can lead to AD. If you click on the magnifying glass at the top right, you can search the forums - I found 12 matches for encephalitis. I would also do a search on EOAD (Early Onset Alzheimer's Disease), which is more age-appropriate for your dad. You can also do a search for Neuroreader and NeuroQuant to see posts regarding the vMRI test.

Your dad's being overweight and having high blood sugar can cause issues, but usually in late onset AD.
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Davida
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Re: Volumetric MRI --- Can anyone offer a speedy explanation

Post by Davida »

IzzysDad

First off, thank you for posting and welcome to the APOE4 community! It sounds like you have already scanned some of the website and found it and other's experiences to be useful. I applaud you for taking such an active role in your father's care, you are to be commended. And, no apologies are necessary for I believe there is never a wrong type of question to ask.

It can be difficult at times waiting for test results and explanations. As you mentioned, the doctor who ordered the test will be gone for the next few weeks. Frustrating!!

vMRI has been used to diagnose Alzheimer's and determine which subtype is most likely. This information can be valuable although difficult to make sense of the report without some advanced medical knowledge. Not my expertise, nor can I give a speedy explanation. I'm sure your doctor will answer these questions and talk with you further about a treatment plan.

I encourage you to continue sharing with us more about you and your dad on Our Stories Also search more onPRIMER for other lifestyle interventions.

All the best,
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Re: Volumetric MRI --- Can anyone offer a speedy explanation

Post by Sara »

IzzysDaddy wrote:Hi Everyone, First time poster. Last week we got the first set of results from a vMRI.
Izzy's Daddy
Hi IzzysDaddy and welcome to the apoe4.info site! I am here to welcome you and reiterate what Davida said, that there is never a wrong question and no apologies are necessary. It is disheartening to receive a medical report and have to wait for a professional interpretation. I am wondering if the physician who is on leave might have a partner who could step in and give you a preliminary review? There is an on-line service that offers radiology second opinions for patients, called docpanel, found at docpanel.com. You would need to have the films to upload and there is a charge. Hopefully someone on the apoe4.com site will be able to help. Good luck.
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Re: Volumetric MRI --- Can anyone offer a speedy explanation

Post by NF52 »

IzzysDaddy wrote: 50 year old male.
At age 30 have viral encephalitis.
...Started having cognitive and memory issues 2+ years ago....
As for health condition - Overweight, active lifestyle, no smoking, no drinking, no non-prescription drug use ever, super social, super smart (still). Cognitive testing over the past 15 months - Either in the 90%+ percentile or at 1% - Almost nothing in the middle. And on multiple CNS tests has scored 99% in multiple areas (as recently as past 3 weeks)...
Welcome Izzy's Daddy,

Let me first say that I think it is problematic to have you receive a report with potentially distressing news without a personal consultation with a doctor. (Lots of people on this site got distressing ApoE 4 news with no explanation or suggestions.)

The only upside is this: nothing you will learn in a few weeks from now changes the fact that you do have a working brain. Maybe not a perfect brain; in a career spent doing lots of diagnostic tests on kids, I have yet to meet a perfect brain. But what I have learned is that we have brains that are hard-wired to compensate for either innate or acquired differences from "the norm". Having spent many years working with kids, their families and their teachers on how to reintegrate them to school after traumatic brain injuries, I learned that the first question should not be "what can't you do?" but "what can you do?"

On some tests you scored at the 99th percentile, meaning you do as well or better than 99 people out of 100 on that test. (While we think of the 50th percentile as an "average" score on a test that has norms, like an IQ test, the truth is that people will score differently on different days. Just like an average height for a 2 year old, there is a range of "normal". So one standard deviation, or "average" is usually anywhere between the 37th percentile and the 63rd percentile.) So you are "superior" at the 99th percentile on some things, and well below level at 1% on other things. It's possible that you've had those differences since you were a kid. (My Dad was a math wizard and artistic, but couldn't hold a tune and sometimes forgot how to spell common words. I can remember dates easily and win spelling contests, but forget faces if they don't look "distinctive" and draw like a 6 year old.)

I suspect, however, that maybe some of the wide swings are in things that changed after your encephalitis. It's possible you could analyze what those are by thinking about the tests that were harder. For example, is it harder to remember a series of numbers or a series of words? Is it harder to remember details of pictures or details of brief 2-3 sentence stories? Is it harder to come up with category names in free recall (naming vegetables, for instance) than it is to point to all the pictures of vegetables in a group of objects. Is it easier to remember vivid experiences 5-10 years ago than it is to remember what you did 2 weeks ago, or what you have planned on your calendar? Is it harder for you to switch between conversations in a group of people than to have a conversation on the phone, or is it easier when you can see the person versus talking on the phone? Is it hard to figure out what the key steps would be to plan for a specific task that you have done and want to do again (like doing your taxes, or fixing something around the house) Is your sense of time off, so that it's hard to know how much time something will take, and your energy flags quickly on extended tasks?

Those are some of the questions that may be much more helpful to you than learning what your hippocampal volume is relative to other people. Because the answer to questions of what is hard and what is easy allows you (sometimes with help from others) to develop compensatory strategies or work-arounds. Plenty of successful professionals have zero ability to organize their calendars, and rely on administrative assistants with that skills. Plenty of people use Google Calendar and email reminders for birthdays, doctor appointments, etc. Plenty of people outsource tasks they can't do.

The best news of all is that we here believe that brains are malleable, and that attention to their care and feeding pays off. For example, maybe some of these changes you're seeing are linked to pre-diabetes insulin resistance, which might mean your brain is somewhat starved for fuel (most of the glucose we take in goes to our brains). That's reversible! Check out our Wiki sections on Insulin Resistance and Insulin Resistance in the brain for great info on this hot topic. My husband was never a fan of vegetables either, but now eats a chicken and romaine salad every day for lunch, and has become friends with mushrooms, zucchini, sweet potato and more without giving up most of his favorite foods. You may want to think about looking at one or more versions of diets: keto, Mediterranean, MIND diet, etc.

If you feel like you'd need some guidance for "head-fitting" strategies (a great term I learned from a speech pathologist), you may want to talk to a neuropsychologist (not a neurologist) or a speech therapist for those areas that most impact your daily functioning.

And to explore this site, to search for topics, quote people so they see your replies, and helpful hints, complete with screen shots (so you don't have to wade through text) see "How-To" Get the most out of the ApoE4.info website

At 50, Izzy's Dad, you have lots of time to "adapt and adopt" what works for you, so that you can enjoy all the roles in your life.
4/4 and still an optimist!
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Re: Volumetric MRI --- Can anyone offer a speedy explanation

Post by circular »

NF52, that was one of the all-time great posts here afaic :)
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Re: Volumetric MRI --- Can anyone offer a speedy explanation

Post by IzzysDaddy »

NF52,

Wow, Thanks so much for sharing so much knowledge and experience. Let me try to answer a few of the questions you asked.


1) Good memory recall from before the encephalitis - in college he was MENSA
2) Key events in last 6 years almost no memory recollection
3) Unable to recognize nieces and nephews in photos with other children of similar age
4) Sometimes doesn't recognize photos of his own wife
5) Things from 2 weeks ago - needs a reminder. No idea what has been written on the calendar even same day. Monthly he double pays 1 or 2 household bills.
6) He uses note pads to write down reminders of his to-do list. Somedays his desk will have 2 or 3 pads with almost the same to-do list - and yet he doesn't get the to-do list done.
7) He has difficulty planning out specific tasks. But he keeps at it and gets it done. Sometimes he will repeatedly make the same mistake on a task over and over. And he says he knows he is making a mistake - but can't stop himself or correct it. And what really frustrates him is once he figures out how to complete the task, if he has to repeat the task immediately he has no recollection of how he did it the first time.
8) He builds lots of stuff. He now writes down the sizes of all the parts he is going to cut. But when the material is cut the sizes are random - Not flipped, no dyslexia - just different sizes altogether - and he will do this 2 or 3 times till he gets the right sizes.
9) Sense of time is gone. He will put 6 or 8 easy things on a to-do list and at the end of the day be lucky to get 1 or 2 done. But didn't waste time. He stayed on task just took 5-6x longer to complete a task.
10) For the past year or so when he works on a completing a challenging task he says he is exhausted from having to concentrate so hard on something that he has done over and over with no thought in the past. And the frustration of knowing he is making the same mistakes over and over and can't stop or correct himself mentally exhausts him.
11) He stopped take a pain medication two weeks ago and now he is usually exhausted by early afternoon. He is dealing with bad insomnia - also since stopping the meds which could also be part of the exhaustion.
12) The memory and cognitive issues became really problematic 2 years ago. In the last year they are getting worse, rapidly. And he now stutters or has to say the start of a sentence over and over till he can complete the sentence.
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Re: Volumetric MRI --- Can anyone offer a speedy explanation

Post by PSu82537%a6r_dnz »

circular wrote:NF52, that was one of the all-time great posts here afaic :)
I would like to second that opinion....many thanks to NF52 for a wonderful post. And best wishes to Izzy and his dad, hope they are able to make productive use of this forum.


And let me ask, is anyone aware of a way that I could order my own volumetric MRI, just between me and the provider without any doctor involved? I am envisioning something like the online blood tests we can order from multiple vendors.
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