Department of Psychology, University of Konstanz, Konstanz, Germany.
Brain Behav. 2023 Mar;13(3):e2925. doi: 10.1002/brb3.2925. Epub 2023 Feb 16.
This article aimed to carry out a narrative literature review of early diagnostic markers of Alzheimer's disease (AD) based on both micro and macro levels of pathology, indicating the shortcomings of current biomarkers and proposing a novel biomarker of structural integrity that associates the hippocampus and adjacent ventricle together. This could help to reduce the influence of individual variety and improve the accuracy and validity of structural biomarker.
This review was based on presenting comprehensive background of early diagnostic markers of AD. We have compiled those markers into micro level and macro level, and discussed the advantages and disadvantages of them. Eventually the ratio of gray matter volume to ventricle volume was put forward.
The costly methodologies and related high patient burden of "micro" biomarkers (cerebrospinal fluid biomarkers) hinder the implementation in routine clinical examination. In terms of "macro" biomarkers- hippocampal volume (HV), there is a large variation of it among population, which undermines its validity Considering the gray matter atrophies while the adjacent ventricular volume enlarges, we assume the hippocampal to ventricle ratio (HVR) is a more reliable marker than HV alone the emerging evidence showed hippocampal to ventricle ratio predicts memory functions better than HV alone in elderly sample.
The ratio between gray matter structures and adjacent ventricular volumes counts as a promising superior diagnostic marker of early neurodegeneration.
本文旨在从微观和宏观病理层面上对阿尔茨海默病（AD）的早期诊断标志物进行叙述性文献综述，指出当前生物标志物的不足，并提出一种将海马体和相邻脑室联系起来的新的结构完整性生物标志物。这有助于减少个体差异的影响，提高结构生物标志物的准确性和有效性。
本综述基于呈现 AD 的早期诊断标志物的全面背景。我们将这些标志物分为微观和宏观两个层面，并讨论了它们的优缺点。最终提出了灰质体积与脑室体积的比值。
“微观”生物标志物（脑脊液生物标志物）的昂贵方法学和相关的高患者负担阻碍了其在常规临床检查中的实施。就“宏观”生物标志物——海马体体积（HV）而言，其在人群中的变化较大，这削弱了其有效性。考虑到灰质萎缩而相邻脑室体积增大，我们假设海马体与脑室的比值（HVR）比单独的 HV 更可靠，新出现的证据表明，在老年样本中，HVR 比单独的 HV 更能预测记忆功能。
灰质结构与相邻脑室体积之比可作为早期神经退行性变的有前途的诊断标志物。
