Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
Maturitas. 2010 Feb;65(2):138-42. doi: 10.1016/j.maturitas.2009.12.006. Epub 2010 Jan 8.
The development of acetyl-cholinesterase inhibitors, and the prospect of future therapies to prevent, or modify, the course of Alzheimer's disease necessitates greater accuracy in diagnosis of this heterogeneous disease. Current diagnosis is based on clinical criteria and neuropathology. This is not always sufficient, and the development of sensitive and specific biomarkers would enable earlier and more accurate diagnosis. Genetic markers, such as Apolipoprotein E4, and cerebrospinal fluid markers such as beta-amyloid and tau, support a diagnosis of Alzheimer's disease. The latter can also predict conversion from mild cognitive impairment to dementia. Imaging markers improve diagnostic accuracy by reflecting brain function or aspects of in vivo pathological changes. In order for such biomarkers to become clinically useful, however, effective treatments need to become available, and long-term follow-up studies are necessary to evaluate the relevance of cross-sectional biomarker changes for the longitudinal natural history of the disease.
乙酰胆碱酯酶抑制剂的发展，以及未来预防或改变阿尔茨海默病病程的治疗方法的前景，需要更准确地诊断这种异质性疾病。目前的诊断基于临床标准和神经病理学。但这并不总是足够的，开发敏感和特异性生物标志物将能够实现更早和更准确的诊断。遗传标志物，如载脂蛋白 E4，以及脑脊液标志物，如β-淀粉样蛋白和tau，支持阿尔茨海默病的诊断。后者还可以预测从轻度认知障碍到痴呆的转化。成像标志物通过反映大脑功能或体内病理变化的某些方面来提高诊断准确性。然而，为了使这些生物标志物具有临床实用性，需要有有效的治疗方法，并且需要进行长期随访研究，以评估横断面生物标志物变化与疾病纵向自然史的相关性。
