Solomon Paul R, Murphy Cynthia A
Department of Psychology, Program in Neuroscience, Williams College, Williamstown, MA, USA.
Expert Rev Neurother. 2008 May;8(5):769-80. doi: 10.1586/14737175.8.5.769.
Recently, focus on early detection, diagnosis and treatment of Alzheimer's disease (AD) has been increasing. The rationale is that, as with any other serious illness, early intervention will lead to better outcomes for patients and families. Despite the intuitive appeal of this rationale, there is discussion and even debate regarding the issues surrounding early detection and treatment. This review begins with a futuristic case that is aimed at focusing this discussion/debate and then proceeds to consider each of the issues including: should AD screening be part of routine physical examinations? is the amyloid hypothesis correct?: implications for diagnosis and treatment? can neuroimaging studies be used to detect brain amyloid? can symptomatic medications be combined to facilitate cognition? can cognitive rehabilitation programs facilitate cognition? and can immunotherapy and other plaque-busting therapies modify the progression of AD?
最近，对阿尔茨海默病（AD）早期检测、诊断和治疗的关注日益增加。其基本原理是，与任何其他严重疾病一样，早期干预将为患者及其家庭带来更好的结果。尽管这一基本原理具有直观的吸引力，但围绕早期检测和治疗的问题仍存在讨论甚至争论。本综述首先从一个未来主义的案例开始，旨在聚焦这一讨论/争论，然后接着考虑每个问题，包括：AD筛查是否应成为常规体检的一部分？淀粉样蛋白假说是否正确？对诊断和治疗有何影响？神经影像学研究能否用于检测脑淀粉样蛋白？有症状的药物能否联合使用以促进认知？认知康复计划能否促进认知？免疫疗法和其他清除斑块的疗法能否改变AD的病程？
