The evolution of preclinical Alzheimer's disease: implications for prevention trials.

The evolution of preclinical Alzheimer's disease: implications for prevention trials.
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DOI:
10.1016/j.neuron.2014.10.038
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发表时间:
2014-11-05
期刊:
影响因子:
16.2
通讯作者:
Johnson, Keith
Johnson, Keith
中科院分区:
医学1区
文献类型:
--
作者:
Sperling, Reisa;Mormino, Elizabeth;Johnson, Keith

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随着该领域开始测试临床前神经退行性疾病的概念,即疾病的假设阶段,即病理生理过程在大脑中开始,但临床症状尚未显现,一些有趣的问题已经出现。特别是,在临床前阿尔茨海默氏病(AD),淀粉样蛋白标记物的神经退行性变的标记物和它们的相对效用在临床正常的老年人中的认知能力下降的预测的时间关系仍有待充分阐明。AD的二级预防试验已经在遗传风险和淀粉样蛋白风险队列中开始,还有几项试验处于计划阶段,这些试验应该提供关于在疾病的非常早期阶段进行干预是否可以真正弯曲临床进展曲线的关键答案。
As the field begins to test the concept of preclinical neurodegenerative disease, the hypothetical stage of disease when the pathophysiological process has begun in the brain but clinical symptoms are not yet manifest, a number of intriguing questions have already arisen. In particular, in preclinical Alzheimer’s disease (AD), the temporal relationship of amyloid markers to markers of neurodegeneration and their relative utility in the prediction of cognitive decline among clinically normal older individuals remains to be fully elucidated. Secondary prevention trials in AD have already begun in both genetic-at-risk and amyloid-at-risk cohorts, with several more trials in the planning stages, that should provide critical answers about whether intervention at this very early stage of disease can truly bend the curve of clinical progression.
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