Frisoni Giovanni B, Perani Daniela, Bastianello Stefano, Bernardi Gaetano, Porteri Corinna, Boccardi Marina, Cappa Stefano F, Trabucchi Marco, Padovani Alessandro
IRCCS Fatebenefratelli, Brescia, Italy; Memory Clinic - Department of Internal Medicine, University Hospital of Geneva, Geneva, Switzerland; LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland.
Vita-Salute San Raffaele University, Nuclear Medicine Unit San Raffaele Hospital, Division of Neuroscience San Raffaele Scientific Institute, Milano, Italy; Italian Association of Nuclear Medicine (AIMN).
Neurobiol Aging. 2017 Apr;52:119-131. doi: 10.1016/j.neurobiolaging.2016.02.033.
Biomarkers of brain amyloidosis and neurodegeneration/synaptic dysfunction are featured in recent diagnostic criteria for Alzheimer's disease. Several gaps in our knowledge, however, need to be filled before they can be adopted clinically. The aim of this article is to describe a roadmap, developed by a multidisciplinary task force, to rationally implement biomarkers for Italian Memory Clinics. This roadmap is based on a framework comprising 5 sequential phases: identification of leads for potentially useful biomarkers; development of clinical assays for clinical disease; evaluation of detection of early stages; definition of operating characteristics in relevant populations; and estimation of reducing disease-associated mortality, morbidity, and disability. The roadmap was devised by identifying current evidence of validity, still missing evidence, and action needed to collect this missing evidence. With appropriate adaptation to local, country-specific circumstances, the roadmap can be translated to other countries.
脑淀粉样变性和神经退行性变/突触功能障碍的生物标志物是最近阿尔茨海默病诊断标准的特色内容。然而，在临床应用之前，我们的知识还存在一些空白需要填补。本文的目的是描述一个由多学科特别工作组制定的路线图，以便为意大利记忆诊所合理应用生物标志物。该路线图基于一个包含5个连续阶段的框架：识别潜在有用生物标志物的线索；开发针对临床疾病的临床检测方法；评估早期阶段的检测情况；确定相关人群的操作特征；以及估计降低疾病相关的死亡率、发病率和残疾率。该路线图是通过识别当前有效性证据、仍然缺失的证据以及收集这些缺失证据所需采取的行动而设计的。经过适当调整以适应特定国家的当地情况后，该路线图可推广到其他国家。
