Hampel H, Bürger K, Teipel SJ, Bokde AL, Zetterberg H, Blennow K.
Core candidate neurochemical and imaging biomarkers of Alzheimer's disease.
Alzheimers Dement. 2008 Jan;4(1):38-48.
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Given that we now know that the pathology of AD starts years, even decades, prior to clinical diagnosis, and given the assumption that earlier therapeutic intervention will be superior to intervention after large numbers of neurons have been destroyed, then the strategic imperative cries for a minimally invasive biomarker test that can be administered at low cost as part of a routine physical exam.
Current imaging and CSF studies provide valuable information, and will continue to do so. Information from these studies can inform the search for further biomarker development. However, I propose that the ultimate biomarker for AD be one that utilizes blood, cheek swabs, or other samples that could be easily obtained in any physician's office. Analysis of these samples could be done outside the physician office, just as is currently done for lipid profiles and large numbers of other tests. Validation of such biomarkers requires long-term longitudinal study of a large cohort with periodic cognitive testing and imaging as well as collection of samples that would be processed and stored in such a way that would not preclude analyses by any current approaches as well as those that may yet be developed.