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Tracking the insidious course of Alzheimer's disease

Nature Medicine volume 18, pages 1342–1343 (2012)Cite this article

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Virginia M-Y Lee

Recent studies comparing clinical and biomarker changes in patients with sporadic Alzheimer's disease with normal subjects and individuals with mild cognitive impairment (MCI) suggest that the pathology of this disease begins in the brain decades before the first cognitive symptoms2. Bateman et al.1 have now confirmed and extended these findings by demonstrating that specific biomarker changes occur 25 years before the onset of cognitive symptoms in an autosomal dominantly inherited familial Alzheimer's disease (FAD) cohort of presenilin and amyloid precursor protein (APP) mutation carriers and noncarriers. By monitoring the sequential changes of five biomarkers over time, Bateman et al.1 showed that a reduction in the concentration of amyloid-β (Aβ42) in cerebrospinal fluid (CSF) was the first change observed in the study subjects, and they inferred that this occurred ∼25 years before the onset of clinical FAD in affected family members. This change was followed by increased signals in positron emission tomography (PET) amyloid imaging, increased concentrations of CSF tau proteins, decreases in glucose use and progressive increases in brain atrophy, all of which were inferred to occur ∼15 years before expected symptom onset.

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References

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Competing interests

M.C. is an employee of UCB Pharma. K.S.K. consults for Genentech, Amgen, iPierian and Nocira.

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Tracking the insidious course of Alzheimer's disease. Nat Med 18, 1342–1343 (2012). https://doi.org/10.1038/nm.2922

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