Role of Fluid Biomarkers and PET Imaging in Early Diagnosis and its Clinical Implication in the Management of Alzheimer's Disease

Shahul Hameed, Jong-Ling Fuh, Vorapun Senanarong, Esther Gunaseli M Ebenezer, Irene Looi, Jacqueline C Dominguez, Kyung Won Park, Ananda Krishna Karanam, Oliver Simon, Shahul Hameed, Jong-Ling Fuh, Vorapun Senanarong, Esther Gunaseli M Ebenezer, Irene Looi, Jacqueline C Dominguez, Kyung Won Park, Ananda Krishna Karanam, Oliver Simon

Abstract

Clinical diagnosis of Alzheimer's disease (AD) is based on symptoms; however, the challenge is to diagnose AD at the preclinical stage with the application of biomarkers and initiate early treatment (still not widely available). Currently, cerebrospinal fluid (CSF) amyloid-β 42 (Aβ42) and tau are used in the clinical diagnosis of AD; nevertheless, blood biomarkers (Aβ42 and tau) are less predictive. Amyloid-positron emission tomography (PET) imaging is an advancement in technology that uses approved radioactive diagnostic agents (florbetapir, flutemetamol, or florbetaben) to estimate Aβ neuritic plaque density in adults with cognitive impairment evaluated for AD and other causes of cognitive decline. There is no cure for AD to date-the disease progression cannot be stopped or reversed; approved pharmacological agents (donepezil, galantamine, and rivastigmine; memantine) provide symptomatic treatment. However, the disease-modifying therapies are promising; aducanumab and CAD106 are in phase III trials for the early stages of AD. In conclusion, core CSF biomarkers reflect pathophysiology of AD in the early and late stages; the application of approved radiotracers have potential in amyloid-PET brain imaging to detect early AD.

Keywords: Alzheimer’s disease; biomarker; blood; cerebrospinal fluid; early diagnosis; positron emission tomography.

Conflict of interest statement

Oliver Simon and Ananda Krishna Karanam are employees of Novartis. The remaining authors have nothing to disclose.

© 2020 – IOS Press and the authors. All rights reserved.

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Source: PubMed

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