Berti Valentina, Polito Cristina, Lombardi Gemma, Ferrari Camilla, Sorbi Sandro, Pupi Alberto
Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", Nuclear Medicine Unit, University of Florence, Largo Brambilla 3, 50134, Florence, FI, Italy.
Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Largo Brambilla 3, 50134, Florence, FI, Italy.
Neurol Sci. 2016 May;37(5):663-72. doi: 10.1007/s10072-016-2477-1. Epub 2016 Jan 20.
The neuropathological processes eventually leading to Alzheimer's disease (AD) are thought to start decades before the appearance of clinical symptoms and the clinical diagnosis of AD dementia. The term "preclinical AD" has been recently introduced to identify this "silent stage" of AD, when the disease is already present, but symptoms are not yet clinically evident. Advances in AD biomarkers have dramatically improved the ability to detect AD pathological processes in vivo in cognitively intact subjects, thus demonstrating the presence of AD pathology in the preclinical phase. This review focuses on the recent advances in the field of neuroimaging and CSF AD biomarkers specifically in the preclinical phase of AD, and aims to discuss the significance that such biomarkers could have in cognitively intact subjects. Even though the use of such biomarkers in AD preclinical phase has contributed to improve our understanding of AD early pathological processes, it raised also a number of new challenges that still remain to be overcome, such as a better definition of the clinical and individual significance of currently known biomarkers in preclinical stages and the development of novel biomarkers of different early AD-related events.
导致阿尔茨海默病（AD）的神经病理过程被认为在临床症状出现及AD痴呆临床诊断前数十年就已开始。术语“临床前AD”最近被引入，以识别AD的这个“无症状阶段”，即疾病已经存在，但症状在临床上尚不明显。AD生物标志物的进展极大地提高了在认知功能完好的受试者体内检测AD病理过程的能力，从而证明了临床前阶段AD病理的存在。本综述聚焦于神经影像学和脑脊液AD生物标志物领域的最新进展，特别是在AD临床前阶段，并旨在讨论此类生物标志物在认知功能完好的受试者中可能具有的意义。尽管在AD临床前阶段使用此类生物标志物有助于增进我们对AD早期病理过程的理解，但它也带来了一些仍有待克服的新挑战，例如更好地界定当前已知生物标志物在临床前阶段的临床和个体意义，以及开发与AD早期相关不同事件的新型生物标志物。
