Biomarkers in the diagnosis and management of Alzheimer’s disease Metabolism, 01/09/2015 Wurtman R – The authors aim to explore the role of biomarkers in diagnosis and management of Alzheimers Disease (AD). Recent observations awaiting confirmation suggest that levels of some plasma phospholipids can also be biomarkers of AD and that reductions in these levels can enable the accurate prediction that a cognitively normal individual will go on to develop MCI or AD within two years. Traditionally Alzheimers Disease (AD) has been diagnosed and its course followed based on clinical observations and cognitive testing, and confirmed postmortem by demonstrating amyloid plaques and neurofibrillary tangles in the brain. But the growing recognition that the disease process is ongoing, damaging the brain long before clinical findings appear, has intensified a search for biomarkers that might allow its very early diagnosis and the objective assessment of its responses to putative treatments. At present at least eight biochemical measurements or scanning procedures are used as biomarkers, usually in panels, by neurologists and others. The biochemical measurements are principally of amyloid proteins and their A-beta precursors, or of tau proteins; the scanning procedures identify brain atrophy (MRI), decreased blood flow and metabolism (fMRI), energy utilization & synaptic number (FDG-PET), impaired connectivity between brain regions (DTI), and metabolic markers of diminished cell number (MRS). Additional proposed biomarkers utilize EEG or MEG for quantifying impairments in connectivity, or genetic analyses to illustrate the heterogeneity of disease processes that can cause MCI syndromes.
Posted on: Fri, 09 Jan 2015 18:06:35 +0000
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