van Norden Anouk G W, van Dijk Ewoud J, de Laat Karlijn F, Scheltens Philip, Olderikkert Marcel G M, de Leeuw F E
Department of Neurology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Biochim Biophys Acta. 2012 Mar;1822(3):340-9. doi: 10.1016/j.bbadis.2011.07.003. Epub 2011 Jul 14.
Alzheimer's disease (AD) is the most common type of dementia. Both its incidence and prevalence are expected to increase exponentially as populations' age worldwide. Despite impressive efforts of research worldwide, neither cure nor effective preventive strategy is available for this devastating disease. Currently there are several hypotheses on what causes AD, with the amyloid hypothesis being the most investigated and accepted hypothesis over the past 20 years. However the exact role of amyloid-β in the onset and progression of AD is not yet fully understood, and even the validity of the amyloid hypothesis itself is still being discussed. This debate is fuelled by the vascular hypothesis, as increasing epidemiological, neuroimaging, pathological, pharmacotherapeutic and clinical studies suggest that vascular pathology plays a key role in the onset and progression of AD. We here will discuss arguments in favor and limitations of both hypotheses within the framework of available literature, but also provide arguments for convergence of both hypotheses. Finally we propose approaches that may aid in unraveling the etiology and treatment of AD. This article is part of a Special Issue entitled: Imaging Brain Aging and Neurodegenerative disease.
阿尔茨海默病（AD）是最常见的痴呆类型。随着全球人口老龄化，其发病率和患病率预计将呈指数级增长。尽管全球范围内进行了大量研究，但对于这种毁灭性疾病，既没有治愈方法，也没有有效的预防策略。目前，关于AD的病因有几种假说，其中淀粉样蛋白假说在过去20年中是研究最多且被广泛接受的假说。然而，淀粉样β蛋白在AD发病和进展中的具体作用尚未完全明确，甚至淀粉样蛋白假说本身的有效性仍在讨论之中。血管假说加剧了这场争论，因为越来越多的流行病学、神经影像学、病理学、药物治疗学和临床研究表明，血管病理在AD的发病和进展中起着关键作用。我们将在现有文献的框架内讨论这两种假说的支持论据和局限性，同时也提供两种假说趋同的论据。最后，我们提出可能有助于揭示AD病因和治疗方法的途径。本文是名为：“脑老化与神经退行性疾病影像学”特刊的一部分。
