阿尔茨海默病:过去、现在与未来
Alzheimer's Disease: Past, Present, and Future.
作者信息
Bondi Mark W, Edmonds Emily C, Salmon David P
机构信息
1Department of Psychiatry,University of California San Diego,School of Medicine,La Jolla,California.
3Department of Neurosciences,University of California San Diego,School of Medicine,La Jolla,California.
出版信息
J Int Neuropsychol Soc. 2017 Oct;23(9-10):818-831. doi: 10.1017/S135561771700100X.
Although dementia has been described in ancient texts over many centuries (e.g., "Be kind to your father, even if his mind fail him." - Old Testament: Sirach 3:12), our knowledge of its underlying causes is little more than a century old. Alzheimer published his now famous case study only 110 years ago, and our modern understanding of the disease that bears his name, and its neuropsychological consequences, really only began to accelerate in the 1980s. Since then we have witnessed an explosion of basic and translational research into the causes, characterizations, and possible treatments for Alzheimer's disease (AD) and other dementias. We review this lineage of work beginning with Alzheimer's own writings and drawings, then jump to the modern era beginning in the 1970s and early 1980s and provide a sampling of neuropsychological and other contextual work from each ensuing decade. During the 1980s our field began its foundational studies of profiling the neuropsychological deficits associated with AD and its differentiation from other dementias (e.g., cortical vs. subcortical dementias). The 1990s continued these efforts and began to identify the specific cognitive mechanisms affected by various neuropathologic substrates. The 2000s ushered in a focus on the study of prodromal stages of neurodegenerative disease before the full-blown dementia syndrome (i.e., mild cognitive impairment). The current decade has seen the rise of imaging and other biomarkers to characterize preclinical disease before the development of significant cognitive decline. Finally, we suggest future directions and predictions for dementia-related research and potential therapeutic interventions. (JINS, 2017, 23, 818-831).
尽管痴呆症在数百年前的古代文献中就有记载(例如,“要善待你的父亲,即使他心智衰退。”——《旧约全书》:《西拉书》3:12),但我们对其潜在病因的了解仅有一个多世纪的历史。阿尔茨海默在仅110年前发表了他如今著名的病例研究,而我们对以他名字命名的这种疾病及其神经心理学后果的现代理解,实际上直到20世纪80年代才开始加速发展。从那时起,我们见证了对阿尔茨海默病(AD)和其他痴呆症的病因、特征及可能治疗方法的基础研究和转化研究的激增。我们回顾这一系列工作,从阿尔茨海默自己的著作和绘图开始,然后跳到始于20世纪70年代和80年代初的现代时期,并对随后每个十年的神经心理学及其他相关工作进行抽样介绍。在20世纪80年代,我们的领域开始了对与AD相关的神经心理学缺陷及其与其他痴呆症(如皮质性痴呆与皮质下痴呆)的鉴别进行基础研究。20世纪90年代继续这些努力,并开始确定受各种神经病理底物影响的特定认知机制。21世纪迎来了对神经退行性疾病在全面痴呆综合征(即轻度认知障碍)出现之前的前驱阶段的研究重点。当前这十年见证了成像和其他生物标志物的兴起,以在显著认知衰退出现之前对临床前疾病进行特征描述。最后,我们提出了痴呆症相关研究及潜在治疗干预的未来方向和预测。(《神经影像学杂志》,2017年,第23卷,第818 - 831页)
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本文引用的文献
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Nat Rev Neurol. 2016-2
Neurodegener Dis. 2016
J Alzheimers Dis. 2015