生物标志物 生物标志物
Rosaleena Mohanty1, Sophia Wheatley1, Giulia Lorenzon1
1Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 24, 2025
概括
根据典型性和严重程度识别的阿尔茨海默病 (AD) 亚型显示出不同的神经成像模式和对治疗的反应. 了解这些亚型对于个性化的AD诊断和治疗至关重要.
科学领域:
- 神经成像和神经科学 神经成像和神经科学
- 生物标志物发现发现
- 个性化医疗是个性化的医疗.
背景情况:
- 阿尔茨海默病 (AD) 呈现出显著的生物学异质性,导致不同的亚型,如典型的AD,边缘主导,皮质主导和最小缩.
- 之前的研究已经基于区域脆弱性,典型性和严重性对这种异质性进行了概念化.
- 关于跨模式比较,共病学的作用,时间演变和AD亚型的治疗反应跟踪,仍然存在关键问题.
研究的目的:
- 用典型性和严重性指标的组合来调查阿尔茨海默病 (AD) 亚型.
- 在多种神经成像方式中比较AD亚型,包括MRI,FDG PET和tau PET.
- 探索共病理和纵向变化对AD亚型及其对治疗的反应的影响.
主要方法:
- 经过检查的AD亚型,以典型性 (中等时与新皮质比率) 和严重性 (全球生物标志物平均值) 定义.
- 在多个国际队列中利用了关于缩 (MRI),低代谢 (FDG PET) 和病理 (tau PET) 的最新评论和新证据.
- 讨论了与粉样β (Aβ),,神经退行,脑血管和α-synuclein病理学有关的发现.
主要成果:
- 典型性和严重性在MRI,FDG PET和tau PET中有效地识别了AD亚型,但亚型无法在各种模式中一致转化.
- 大脑血管共病症,特别是动脉样硬化,对缩和低代谢亚型产生了差异性影响,而α-synuclein没有.
- 纵向分析显示,边缘主导和最小缩亚型随着时间的推移而趋同,女性显示较早的缩和白质异常.
- 亚尔茨海默病亚型对多尼佩西尔治疗的反应有所差异,而最小的缩和皮质主导的亚型显示出更大的益处.
结论:
- 典型性和严重性的结合为研究阿尔茨海默病 (AD) 中的神经生物学异质性的研究提供了一个框架.
- 多模式和纵向亚尔茨海默病的亚型是推进个性化诊断,预后和治疗策略的必要条件.
- 对阿尔茨海默症亚型的计算为更定制的治疗干预提供了途径.
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