Pro Can biomarkers be gold standards in Alzheimers disease 英文参考文献.docVIP

Sperling and Johnson Alzheimer’s Research Therapy 2010,2:17 /content/2/3/17 VIEWPOINT Pro: Can biomarkers be gold standards in Alzheimer’s disease? Reisa Sperling* and Keith Johnson ? uid (CSF) markers of Aβ; evidence of synaptic F]? uorodeoxyglucose-PET or Abstract dysfunction, detected by [ 18 Recent advances in biomarkers for Alzheimer’s disease (AD) now allow the visualization of one of the hallmark pathologies of AD in vivo, and combination biomarker pro?les can now approximate the diagnostic accuracy of autopsy in patients with dementia. Biomarkers are already employed in clinical trials in prodromal AD for both subject selection and in monitoring therapeutic response. Ultimately the greatest utility of biomarkers may be in the preclinical stages of AD, to identify and track progression of the disease prior to signi?cant cognitive impairment, at the point when disease- modifying therapies are likely to be most e?cacious. functional magnetic resonance imaging (MRI); and evi- dence of neuro degenera tion or neuronal loss, detected by CSF tau and atrophy detectable with volumetric MRI. We will brie? y review the utility of these biomarkers in clinical diagnosis and research criteria across the con- tinuum from AD dementia back to cognitively normal older individuals who may be in presymptomatic stages of AD. By the stage of AD dementia, there is clear evidence of abnormality in all biomarker categories, including low CSF Aβ and elevated CSF tau, increased PETamyloid tracer retention, [ F]? uorodeoxyglucose hypometabolism, 18 default network disruption on functional MRI, cortical thinning and hippocampal atrophy on volumetric MRI. It e past decade has seen tremendous advances in the is widely acknowledged that a small percentage of development of biomarkers for Alzheimer’s disease (AD), clinically diagnosed AD patients do not meet autopsy criteria f