Detecting Alzheimer disease before it happens: The key to prevention?

摘要

Although consensus is rare in the Alzheimer disease (AD) research community, there is widespread agreement that the development of AD prevention strategies is of paramount importance. However, primary prevention trials relying on clinical outcome measures are exceedingly time and labor-intensive, requiring thousands of subjects followed over several years. One approach to accelerating the process is to validate surrogate markers of AD pathology for use in prevention studies. Three surrogate markers, namely CSF total tau, phosphorylated tau, and the lipid peroxidation product F2-isoprostanes, have been identified and validated as markers that are elevated in CSF in established AD, while CSF beta amyloid (Abeta)1-42 is lower in established AD compared to control subjects. The sensitivity of these CSF markers for detecting presymptomatic pathologic changes, however, has not been established.