학술논문

Tracking pathophysiological processes in Alzheimer's disease: an updated hypothetical model of dynamic biomarkers
Document Type
article
Source
The Lancet Neurology. 12(2)
Subject
Biomedical and Clinical Sciences
Neurosciences
Clinical Sciences
Brain Disorders
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)
Alzheimer's Disease
Neurodegenerative
Aging
Acquired Cognitive Impairment
Dementia
2.1 Biological and endogenous factors
Detection
screening and diagnosis
Aetiology
4.1 Discovery and preclinical testing of markers and technologies
Neurological
Alzheimer Disease
Amyloid beta-Peptides
Biomarkers
Cognition Disorders
Humans
Models
Biological
Nonlinear Dynamics
tau Proteins
Neurology & Neurosurgery
Clinical sciences
Language
Abstract
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 β (Aβ) and tau, might be initiated independently in sporadic AD, in which we hypothesise that an incident Aβ pathophysiology can accelerate antecedent limbic and brainstem tauopathy.