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是时候分享路易体痴呆症的阿尔茨海默病生物标志物结果了。

It is time to share Alzheimer biomarker results in dementia with Lewy bodies.

作者信息

Armstrong Melissa J, Grill Joshua D, Tropea Thomas F

机构信息

Department of Neurology University of Florida College of Medicine Gainesville Florida USA.

Norman Fixel Institute for Neurological Diseases Gainesville Florida USA.

出版信息

Alzheimers Dement (Amst). 2025 Jul 9;17(3):e70144. doi: 10.1002/dad2.70144. eCollection 2025 Jul-Sep.

Abstract

UNLABELLED

There are increasing calls for sharing individual biomarker results with participants in dementia research. No studies investigate returning Alzheimer's disease (AD) biomarker results to individuals with syndromic dementia with Lewy bodies (DLB) even though most of these individuals have both pathologies. This perspective argues that AD biomarkers are valid, interpretable, and actionable, particularly relating to expected prognosis and treatment effects, in people with DLB. Thus, there is an ethical imperative to study AD biomarker result sharing in these patients. This will require revising current disclosure practices. Areas of need include unique pre- and post-test education and careful assessment of the readiness to receive results and post-result responses in people with DLB given the frequency of neuropsychiatric symptoms in this group. Studying responses to sharing AD biomarkers in people with DLB will also inform other dementia settings (e.g., returning synuclein results to individuals with syndromic AD) and neurodegenerative diseases more broadly.

HIGHLIGHTS

There are increasing calls for biomarker result sharing in dementia research.No processes exist to guide result sharing in dementia with Lewy bodies (DLB).Alzheimer biomarker results in DLB are valid, interpretable, and actionable.Research is needed on the methods and effects of sharing with people with DLB.Research is needed for sharing evidence of co-pathology across neurodegenerations.

摘要

未标注

在痴呆症研究中,要求与参与者分享个体生物标志物结果的呼声越来越高。尽管大多数患有路易体痴呆(DLB)综合征的个体同时存在两种病理情况,但尚无研究探讨将阿尔茨海默病(AD)生物标志物结果反馈给这些个体。本文观点认为,AD生物标志物在DLB患者中是有效的、可解释的且可采取行动的,特别是在预期预后和治疗效果方面。因此,从伦理角度出发,有必要研究在这些患者中分享AD生物标志物结果的情况。这将需要修订当前的披露做法。需要关注的领域包括针对DLB患者进行独特的检测前和检测后教育,以及仔细评估其接受结果的准备情况和结果反馈后的反应,因为该群体中神经精神症状较为常见。研究DLB患者对AD生物标志物结果分享的反应,也将更广泛地为其他痴呆症情况(例如,将α-突触核蛋白结果反馈给患有AD综合征的个体)和神经退行性疾病提供参考。

重点

在痴呆症研究中,要求分享生物标志物结果的呼声越来越高。目前没有流程来指导路易体痴呆(DLB)患者的结果分享。DLB患者的阿尔茨海默病生物标志物结果是有效的、可解释的且可采取行动的。需要研究与DLB患者分享结果的方法和效果。需要研究跨神经退行性疾病分享共同病理证据的情况。

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本文引用的文献

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Alzheimer's disease biomarkers and the tyranny of treatment.阿尔茨海默病生物标志物与治疗的暴政。
EBioMedicine. 2024 Oct;108:105291. doi: 10.1016/j.ebiom.2024.105291. Epub 2024 Oct 3.

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