Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany; DZNE, German Center for Neurodegenerative Diseases, Rostock, Germany.
Department of Nuclear Medicine, University of Cologne, Cologne, Germany.
Lancet Neurol. 2015 Oct;14(10):1037-53. doi: 10.1016/S1474-4422(15)00093-9. Epub 2015 Aug 26.
Alzheimer's disease is a progressive neurodegenerative disease that typically manifests clinically as an isolated amnestic deficit that progresses to a characteristic dementia syndrome. Advances in neuroimaging research have enabled mapping of diverse molecular, functional, and structural aspects of Alzheimer's disease pathology in ever increasing temporal and regional detail. Accumulating evidence suggests that distinct types of imaging abnormalities related to Alzheimer's disease follow a consistent trajectory during pathogenesis of the disease, and that the first changes can be detected years before the disease manifests clinically. These findings have fuelled clinical interest in the use of specific imaging markers for Alzheimer's disease to predict future development of dementia in patients who are at risk. The potential clinical usefulness of single or multimodal imaging markers is being investigated in selected patient samples from clinical expert centres, but additional research is needed before these promising imaging markers can be successfully translated from research into clinical practice in routine care.
阿尔茨海默病是一种进行性神经退行性疾病,临床上通常表现为孤立性的健忘症缺陷,进而发展为特征性痴呆综合征。神经影像学研究的进展使得能够以越来越高的时间和区域细节来描绘阿尔茨海默病病理学的各种分子、功能和结构方面。越来越多的证据表明,与阿尔茨海默病相关的不同类型的影像学异常在疾病发病过程中遵循一致的轨迹,并且在疾病临床表现之前数年就可以检测到最初的变化。这些发现激发了临床对使用特定的阿尔茨海默病影像学标志物来预测有风险的患者未来痴呆发展的兴趣。在临床专家中心的选定患者样本中,正在研究单一或多模态影像学标志物的潜在临床实用性,但在这些有前途的影像学标志物能够成功地从研究转化为常规护理中的临床实践之前,还需要进一步的研究。