Staging neurodegenerative disorders: structural, regional, biomarker, and functional progressions

Area of Science:

• Neuroscience
• Neurology
• Biomarker Research

Background:

• Neurodegenerative disorders involve progressive loss of brain structure and function.
• Clinical staging classifies patients based on diagnosis, prognosis, and outcomes.
• Preclinical staging in animals uses models to understand disease progression.

Purpose of the Study:

• To review the concept of staging in neurodegenerative disorders.
• To highlight challenges in current staging methods, particularly for Alzheimer's disease and Parkinson's disease.
• To emphasize the need for integrating new data into staging models.

Main Methods:

• Review of existing staging concepts, focusing on Braak staging.
• Discussion of challenges posed by mild cognitive impairment and longitudinal magnetic resonance imaging.
• Consideration of emerging biomarkers and neurotransmitter system imbalances.

Main Results:

• Current staging models, while based on foundational concepts like Braak staging, are insufficient.
• New data from clinical observations and laboratory research are not adequately incorporated.
• Mild cognitive impairment and advanced imaging present challenges to existing staging frameworks.

Conclusions:

• Staging neurodegenerative diseases requires dynamic models that incorporate diverse data.
• Biomarkers like amyloid precursor protein and neurotransmitter imbalances are crucial for future staging.
• Improved staging will enhance diagnosis, prognosis, and treatment strategies for neurodegenerative disorders.