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      Hypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade

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          Abstract

          Currently available evidence strongly supports the position that the initiating event in Alzheimer's disease (AD) is related to abnormal processing of beta-amyloid (Abeta) peptide, ultimately leading to formation of Abeta plaques in the brain. This process occurs while individuals are still cognitively normal. Biomarkers of brain beta-amyloidosis are reductions in CSF Abeta(42) and increased amyloid PET tracer retention. After a lag period, which varies from patient to patient, neuronal dysfunction and neurodegeneration become the dominant pathological processes. Biomarkers of neuronal injury and neurodegeneration are increased CSF tau and structural MRI measures of cerebral atrophy. Neurodegeneration is accompanied by synaptic dysfunction, which is indicated by decreased fluorodeoxyglucose uptake on PET. We propose a model that relates disease stage to AD biomarkers in which Abeta biomarkers become abnormal first, before neurodegenerative biomarkers and cognitive symptoms, and neurodegenerative biomarkers become abnormal later, and correlate with clinical symptom severity. Copyright 2010 Elsevier Ltd. All rights reserved.

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          Author and article information

          Journal
          The Lancet Neurology
          The Lancet Neurology
          Elsevier BV
          14744422
          January 2010
          January 2010
          : 9
          : 1
          : 119-128
          10.1016/S1474-4422(09)70299-6
          2819840
          20083042
          © 2010

          https://www.elsevier.com/tdm/userlicense/1.0/

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