Alzheimer disease: Biomarker trajectories across stages of Alzheimer disease

摘要

Alzheimer disease features neurobiological changes long before the first symptoms of cognitive decline. Results from a new study to define the orderly changes of markers of amyloidosis and neurodegeneration over the disease course will assist the development of biomarker-based protocols for early diagnosis, and disease-modifying drugs.When I consult patients with Alzheimer disease (AD) and their relatives, the uneasiest part of the talk concerns therapy. After the clinical characteristics of currently approved drugs are described (unpredictable, purely symptomatic, and effective in the short term if at all), a frequent reaction is, "how come, in the third millennium, you still do not have an effective drug for AD?" My efforts to instill hope by recounting the great advances made in recent years in understanding AD pathophysiology are usually greeted with interest but little enthusiasm when translated into the patients future. A recent study by Jack and colleagues touches on one of the most debated issues in this field, and one that is ripe with consequences for patient care: the mapping of the sequence of neurobiological events leading from normality to dementia in AD.