Developing robust biomarkers for vascular cognitive disorders: adding 'V' to the AT(N) research framework.

Area of Science:

• Neurology
• Biomarker Research
• Neurodegenerative Diseases

Background:

• The AT(N) framework defines Alzheimer's disease biologically.
• Cerebrovascular disease (CVD) frequently co-occurs with Alzheimer's lesions.
• The AT(N) framework requires extension with biomarkers for comorbidities like CVD.

Purpose of the Study:

• To review requirements for adding a 'V' (for CVD) to the AT(N) framework.
• To examine current biomarkers for definitive CVD detection.

Main Methods:

• Review of existing literature on CVD biomarkers.
• Focus on neuroimaging and biochemical markers.
• Assessment of biomarker standardization and validation.

Main Results:

• Neuroimaging MRI techniques show significant promise for CVD biomarker detection.
• Challenges include technique standardization, result validation, and assessing total CVD burden.
• Retinal imaging offers a potential view of cerebral vasculature; biochemical markers lack established CVD specificity.

Conclusions:

• CVD biomarkers have advanced rapidly.
• Further validation and specificity determination are necessary.
• Reliable CVD biomarkers are needed to establish the 'V' in the AT(N) framework.