Department of Neurology, First Hospital, Shanxi Medical University, Taiyuan, 030000, China.
Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
Neurosci Bull. 2022 Jun;38(6):677-691. doi: 10.1007/s12264-022-00836-7. Epub 2022 Mar 19.
Since the establishment of the biomarker-based A-T-N (Amyloid/Tau/Neurodegeneration) framework in Alzheimer's disease (AD), the diagnosis of AD has become more precise, and cerebrospinal fluid tests and positron emission tomography examinations based on this framework have become widely accepted. However, the A-T-N framework does not encompass the whole spectrum of AD pathologies, and problems with invasiveness and high cost limit the application of the above diagnostic methods aimed at the central nervous system. Therefore, we suggest the addition of an "X" to the A-T-N framework and a focus on peripheral biomarkers in the diagnosis of AD. In this review, we retrospectively describe the recent progress in biomarkers based on the A-T-N-X framework, analyze the problems, and present our perspectives on the diagnosis of AD.
自阿尔茨海默病（AD）基于生物标志物的 A-T-N（淀粉样蛋白/tau 蛋白/神经退行性变）框架建立以来，AD 的诊断变得更加精确，并且基于该框架的脑脊液检测和正电子发射断层扫描检查已被广泛接受。然而，A-T-N 框架并未涵盖 AD 病理学的全貌，且具有侵袭性和高成本的问题限制了上述针对中枢神经系统的诊断方法的应用。因此，我们建议在 A-T-N 框架中添加一个“X”，并关注 AD 的外周生物标志物。在这篇综述中，我们回顾性地描述了基于 A-T-N-X 框架的生物标志物的最新进展，分析了存在的问题，并对 AD 的诊断提出了我们的观点。
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