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[The DIAN study].

Hiroyuki Shimada¹

¹Department of Geriatric Medicine, and Neurology, Graduate School of Medicine, Osaka City University.

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|October 9, 2013

Summary

This summary is machine-generated.

Autosomal dominant Alzheimer's disease (AD) biomarker changes, including reduced Aβ42, begin 15-20 years before symptom onset. This finding informs AD prevention trials targeting preclinical stages.

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Area of Science:

Neurodegenerative diseases
Biomarker research
Genetics of Alzheimer's disease

Context:

Autosomal dominant Alzheimer's disease (AD) provides a unique model to study disease progression.
Understanding presymptomatic AD is crucial for developing effective prevention strategies.
The DIAN and API studies investigate early pathophysiological changes in familial AD.

Purpose:

To compare pathophysiological markers in mutation carriers versus non-carriers of autosomal dominant AD.
To establish a timeline of biomarker changes preceding clinical symptom onset in AD.
To inform the design of AD prevention trials, such as the A4 study.

Summary:

Biomarker changes, including decreased cerebrospinal fluid (CSF) Aβ42, initiate 15-20 years before symptom onset in autosomal dominant AD.
A cascade of events follows, including amyloid-beta deposition, tau increase, hippocampal atrophy, and metabolic changes, preceding cognitive decline.
Clinical trials like API and A4 are evaluating anti-amyloid therapies in early-onset and preclinical AD, respectively.

Impact:

Provides a detailed timeline of AD's preclinical progression, crucial for early intervention.
Supports the development of targeted prevention therapies for individuals at high risk of AD.
Highlights the importance of biomarker monitoring in AD research and clinical trials.