中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (12): 2579-2580.doi: 10.4103/NRR.NRR-D-23-01938

• 观点:退行性病与再生 • 上一篇    下一篇

血管性认知障碍和痴呆的分子生物标志物:现状和未来方向

  

  • 出版日期:2024-12-15 发布日期:2024-03-30

Molecular biomarkers for vascular cognitive impairment and dementia: the current status and directions for the future

Satoshi Hosoki*, Perminder S. Sachdev   

  1. Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia (Hosoki S, Sachdev PS) 
    Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan (Hosoki S)
  • Online:2024-12-15 Published:2024-03-30
  • Contact: Satoshi Hosoki, MD, PhD, s.hosoki@unsw.edu.au.
  • Supported by:
    This work was supported by the Japan Society for the Promotion of Science Overseas Research Fellow, the fellowship of Astellas Foundation for Research on Metabolic Disorders and the Japanese Society of Neurology grants for overseas study “Young Researcher Overseas Training Program” (SH) and NHMRC CRE grant 2006765 (to PSS).

摘要: https://orcid.org/0000-0002-4241-3677 (Satoshi Hosoki)

Abstract: Dementia is a syndrome with various underlying pathologies acting independently or in concert to cause cognitive dysfunction. The development of disease-specific treatments and targeted prevention strategies requires precise clinical sub-typing via etiology and pathophysiological processes. Furthermore, recent research advances in biomarkers, especially for Alzheimer’s disease (AD) diagnosis, have improved diagnostic precision for dementia. This has led to the proposal of an AT(N) framework for AD diagnosis, with A, T, and N signifying the demonstrated presence of amyloid (A) and tau (T) pathologies as well as neurodegeneration (N) respectively. Many authors have proposed to add other pathophysiological mechanisms to the traditional AT(N) framework, such as neuroimmune dysregulation, synaptic dysfunction, and/or blood-brain barrier (BBB) alterations, to make the ATX(N) more accommodating of a range of pathologies important for dementia. This has included the special consideration of vascular pathogenesis being represented by a “V” (Sachdev, 2020). This indicates that cerebrovascular disease (CVD) is a common cause of dementia alone or in combination with AD, and the importance of developing biomarkers of vascular “V” brain pathology has been argued. Research progress in vascular cognitive impairment and dementia (VCID), the second most common cause of dementia, has however been slow, partly because of limited research in VCID relative to AD. The diagnosis of VCID presently relies mainly on clinical information and neuroimaging including magnetic resonance imaging and computed tomography. Consequently, there exists an imperative to develop molecular biomarkers for VCID with high sensitivity and accuracy.