Department of Psychiatry, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.
Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.
Adv Exp Med Biol. 2023;1411:301-326. doi: 10.1007/978-981-19-7376-5_14.
Alzheimer's disease (AD) is the most prevalent neurocognitive disorder. Due to the ineffectiveness of treatments targeting the amyloid cascade, molecular biomarkers for neuroinflammation are attracting attention with increasing knowledge about the role of neuroinflammation in the pathogenesis of AD. This chapter will explore the results of studies using molecular imaging for diagnosing AD and mild cognitive impairment (MCI). Because it is critical to interpreting the data to understand which substances are targeted in molecular imaging, this chapter will discuss the two most significant targets, microglia and astrocytes, as well as the best-known radioligands for each. Then, neuroimaging results with PET neuroinflammation imaging will be reviewed for AD and MCI. Although a growing body of evidence has suggested that these molecular imaging biomarkers for neuroinflammation may have a role in the diagnosis of AD and MCI, the findings are inconsistent or cross-sectional, which indicates that it is difficult to apply the contents in practice due to the need for additional study. In particular, because the results of multiple interventions targeting neuroinflammation were inconclusive, molecular imaging markers for neuroinflammation can be used in combination with conventional markers to select appropriate patients for early intervention for neuroinflammation rather than as a single marker.
阿尔茨海默病(AD)是最常见的神经认知障碍。由于针对淀粉样蛋白级联的治疗方法效果不佳,随着对神经炎症在 AD 发病机制中的作用的认识不断增加,神经炎症的分子生物标志物越来越受到关注。本章将探讨使用分子影像学诊断 AD 和轻度认知障碍(MCI)的研究结果。由于了解要针对哪些物质进行分子成像以解释数据至关重要,因此本章将讨论两个最重要的靶标,小胶质细胞和星形胶质细胞,以及每个靶标最著名的放射性配体。然后,将回顾用于 AD 和 MCI 的 PET 神经炎症成像的神经影像学结果。尽管越来越多的证据表明,这些神经炎症的分子影像学生物标志物可能在 AD 和 MCI 的诊断中具有作用,但这些发现并不一致或只是横断面研究,这表明由于需要进一步研究,难以在实践中应用这些内容。特别是由于针对神经炎症的多种干预措施的结果不一致,因此可以将神经炎症的分子成像标记物与常规标记物结合使用,以选择适当的患者进行神经炎症的早期干预,而不是将其作为单一的标记物。