Tracking pathophysiological processes in Alzheimer's disease: an updated hypothetical model of dynamic biomarkers

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• 作者：Prof Dr Clifford R Jack ; MD^a ; ^{jack.clifford@mayo.edu} ; Prof David S Knopman ; MD^b ; Prof William J Jagust ; MD^d ; Prof Ronald C Petersen ; MD^b ; Prof Michael W Weiner ; MD^e ; Prof Paul S Aisen ; MD^f ; Prof Leslie M Shaw ; PhD^g ; Prashanthi Vemuri ; PhD^a ; Heather J Wiste^c ; Stephen D Weigand^c ; Timothy G Lesnick^c ; Vernon S Pankratz ; PhD^c ; Michael C Donohue ; PhD^f ; Prof John Q Trojanowski ; PhD^g
• 刊名：Lancet Neurology
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：12
• 期：2
• 页码：207-216
• 全文大小：424 K

文摘

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Summary

In 2010, we put forward a hypothetical model of the major biomarkers of Alzheimer's disease (AD). The model was received with interest because we described the temporal evolution of AD biomarkers in relation to each other and to the onset and progression of clinical symptoms. Since then, evidence has accumulated that supports the major assumptions of this model. Evidence has also appeared that challenges some of our assumptions, which has allowed us to modify our original model. Refinements to our model include indexing of individuals by time rather than clinical symptom severity; incorporation of interindividual variability in cognitive impairment associated with progression of AD pathophysiology; modifications of the specific temporal ordering of some biomarkers; and recognition that the two major proteinopathies underlying AD biomarker changes, amyloid ¦Â (A¦Â) and tau, might be initiated independently in sporadic AD, in which we hypothesise that an incident A¦Â pathophysiology can accelerate antecedent limbic and brainstem tauopathy.