Recent Progress in Alzheimer's Disease Research, Part 3: Diagnosis and Treatment

Abstract

The field of Alzheimer's disease (AD) research has grown exponentially over the past few decades, especially since the isolation and identification of amyloid-β from postmortem examination of the brains of AD patients. Recently, the Journal of Alzheimer's Disease (JAD) put forth approximately 300 research reports which were deemed to be the most influential research reports in the field of AD since 2010. JAD readers were asked to vote on these most influential reports. In this 3-part review, we review the results of the 300 most influential AD research reports to provide JAD readers with a readily accessible, yet comprehensive review of the state of contemporary research. Notably, this multi-part review identifies the "hottest" fields of AD research providing guidance for both senior investigators as well as investigators new to the field on what is the most pressing fields within AD research. Part 1 of this review covers pathogenesis, both on a molecular and macro scale. Part 2 review genetics and epidemiology, and part 3 covers diagnosis and treatment. This part of the review, diagnosis and treatment, reviews the latest diagnostic criteria, biomarkers, imaging, and treatments in AD.

Keywords: Alzheimer’s disease; MRI; PET; biomarkers; diagnosis; mild cognitive impairment; treatment.

Fig.1

The relationship of clinical disease stage to biomarker magnitude (arbitrary units). Notice the long period of cognitively normal preclinical AD, quickly progressing though MCI to AD dementia. Image adapted with permission from [15].

Fig.2

Representative PET (top row) and MRI (bottom row) images of an MCI individual that progressed to AD dementia (left) compared to an MCI individual who did not progress to AD dementia. Notice increased amyloid loading and hippocampal atrophy in the PET images and ventricular enlargement in the MRI images in progressor individual (left). Image reprinted with permissionfrom [55].

Fig.3

Tau and Aβ PET images in cognitively healthy controls (top-CDR0) and AD patients (bottom-CDR>0). Notice that tau deposition is a better predictor of cognitive decline than Aβ deposition. Figure reprinted with permission from [73]. CDR, Clinical Dementia Rating; SUVR, standardized uptake value ratio

Fig.4

Diffusion tensor image comparing the increase of fractional anisotropy of AD patients (blue-purple scale) with healthy controls (red-yellow scale). Image reprinted with permission from [5].