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特集 神経疾患のバイオマーカー
文献概要
はじめに
脳脊髄液（cerebrospinal fluid：CSF）アミロイドβ（amyloid beta：Aβ）とタウはアルツハイマー病（Alzheimer's disease：AD）の臨床診断，血管性認知症（vascular dementia：VaD）や非AD型認知症との鑑別，治療可能な認知症の除外，軽度認知障害（mild cognitive impairment：MCI）からAD発症の予測，抗Aβ抗体やセクレターゼ阻害薬などの病態修飾薬の評価のためのバイオマーカーとしての世界的なエビデンスを積み重ねてきた。一方で，PiB-PETによって脳アミロイド蓄積が可視化できるようになり，バイオマーカーとしての神経画像の重要性も増している。2004年に米国で開始されたADの早期診断・発症に関わる因子の解明を目指すAlzheimer's Disease Neuroimaging Initiative（ADNI）は，現在，日本，ヨーロッパ，オーストラリアでも進展しており，2009年から成果が報告されつつある。本稿ではADのバイオマーカーのエビデンスをまとめ，ADNI以後のCSFマーカー研究の進歩とPiB-PET，FDG-PET，MRI統計処理画像，標準化された神経心理検査との関連などを紹介する。
脳脊髄液（cerebrospinal fluid：CSF）アミロイドβ（amyloid beta：Aβ）とタウはアルツハイマー病（Alzheimer's disease：AD）の臨床診断，血管性認知症（vascular dementia：VaD）や非AD型認知症との鑑別，治療可能な認知症の除外，軽度認知障害（mild cognitive impairment：MCI）からAD発症の予測，抗Aβ抗体やセクレターゼ阻害薬などの病態修飾薬の評価のためのバイオマーカーとしての世界的なエビデンスを積み重ねてきた。一方で，PiB-PETによって脳アミロイド蓄積が可視化できるようになり，バイオマーカーとしての神経画像の重要性も増している。2004年に米国で開始されたADの早期診断・発症に関わる因子の解明を目指すAlzheimer's Disease Neuroimaging Initiative（ADNI）は，現在，日本，ヨーロッパ，オーストラリアでも進展しており，2009年から成果が報告されつつある。本稿ではADのバイオマーカーのエビデンスをまとめ，ADNI以後のCSFマーカー研究の進歩とPiB-PET，FDG-PET，MRI統計処理画像，標準化された神経心理検査との関連などを紹介する。
参考文献
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