Espert R, Bertolín J M, Navarro J F, González A
Area de Psicobiología, Facultad de Psicología, Universitat de Valencia.
Rev Neurol. 1995 Jan-Feb;23(119):77-85.
In the previous paper, the first one in our trilogy about dementias, we introduce the concept and evaluate the diagnostic methods and the data provided by epidemiological investigation. In this paper we review the different biological diagnostic markers, based, in the first place, on the studies of neuroimage (computerized axial tomography, magnetic resonance, functional neuroimage techniques) and those properly neurophysiological; in the second place, the anatomopathological and physiopathological markers are examined; and, in the third place, those based on the modern genetic investigations. In the absence of an 'univocal biological marker', the current investigation about markers is on the way to the study of abnormal proteins discovered in the brain, of the modifications detected in the cellular metabolism, of the manifestations of the immunologic mechanisms and of the involved inflammatory processes, and is on the way to the advances and proximate perspectives of molecular genetics and animal models. Meanwhile, the diagnostic for the main dementia, due to Alzheimer's disease, is basically a clinic, exclusive and residual one, mainly in its initial stadium.
在我们关于痴呆症的三部曲的第一篇论文中，我们介绍了该概念，并评估了诊断方法以及流行病学调查提供的数据。在本文中，我们首先基于神经影像研究（计算机断层扫描、磁共振成像、功能神经影像技术）以及那些真正的神经生理学研究，回顾不同的生物诊断标志物；其次，检查解剖病理学和生理病理学标志物；第三，回顾基于现代基因研究的标志物。在缺乏“明确的生物标志物”的情况下，目前对标志物的研究正朝着对大脑中发现的异常蛋白质、细胞代谢中检测到的变化、免疫机制的表现以及相关炎症过程的研究方向发展，并且正朝着分子遗传学和动物模型的进展及近期前景发展。同时，主要由阿尔茨海默病导致的痴呆症的诊断基本上是一种临床诊断，具有排他性和残余性，主要在其初始阶段。
