Seibyl J, Jennings D, Tabamo R, Marek K
Institute for Neurodegenerative Disorders, New Haven, CT 06510, USA.
Minerva Med. 2005 Oct;96(5):353-64.
The development of imaging biomarkers which target specific sites in the brain represents a significant advance in neurodegenerative diseases and Parkinson's disease with the promise of new and improved approaches for the early and accurate diagnosis of disease as well as novel ways to monitor patients and assess treatment. The 3 major applications of imaging may play a role in Parkinson's disease include: 1) the use of neuroimaging as a biomarker of disease in order to improve the accuracy, timeliness, and reliability of diagnosis; 2) objective monitoring of the progression of disease to provide a molecular phenotype of Parkinson's disease which may illuminate some of the sources of clinical variability; 3) the evaluation of so-called ''disease-modifying'' treatments designed to retard the progression of disease by interfering with pathways thought implicated in the ongoing neuronal loss or replace dopamine-producing cells. Each of these areas has shown a numbers of critical clinical investigations which have better defined the utility of the imaging tools to these tasks. Nonetheless, current unresolved issues around the clinical role of neuroimaging in monitoring patients over time and validation of quantitative imaging measures of dopaminergic function are immediate issues for the field and the subject of current research efforts and the extension of the lessons learned in Parkinson's to other neurodegenerative diseases including Alzheimer's dementia.
针对大脑特定部位的成像生物标志物的发展，在神经退行性疾病和帕金森病领域代表了一项重大进展，有望带来新的、改进的疾病早期准确诊断方法，以及监测患者和评估治疗的新途径。成像在帕金森病中的三大主要应用包括：1）将神经成像用作疾病生物标志物，以提高诊断的准确性、及时性和可靠性；2）客观监测疾病进展，以提供帕金森病的分子表型，这可能有助于阐明临床变异性的一些来源；3）评估所谓的“疾病修饰”疗法，这些疗法旨在通过干扰与持续神经元丢失相关的通路或替代产生多巴胺的细胞来延缓疾病进展。这些领域中的每一个都开展了一些关键的临床研究，这些研究进一步明确了成像工具在这些任务中的效用。尽管如此，目前围绕神经成像在长期监测患者中的临床作用以及多巴胺能功能定量成像测量的验证等尚未解决的问题，是该领域亟待解决的问题，也是当前研究工作的主题，并且要将在帕金森病中吸取的经验教训扩展到包括阿尔茨海默病性痴呆在内的其他神经退行性疾病。
