4.7 Article

Willis Lecture: Biomarkers for Inflammatory White Matter Injury in Binswanger Disease Provide Pathways to Precision Medicine

期刊

STROKE
卷 53, 期 11, 页码 3514-3523

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/STROKEAHA.122.039211

关键词

Alzheimer disease; biomarkers; blood-brain barrier; matrix metalloproteinases; tomography

资金

  1. National Institutes of Health (NIH) [RO1 NS052305, RO1 NS068048, UH3 NS100598, P20 AD068077]
  2. National Center for Advancing Translational Sciences, NIH [UL1TR001449]
  3. NIH [S10OD025313]

向作者/读者索取更多资源

Binswanger disease is a type of vascular cognitive impairment and dementia. Biomarkers can aid in early diagnosis, such as using magnetic resonance imaging and cerebrospinal fluid or positron emission tomography to detect vascular disease-related proteins. Vascular disease accelerates cognitive decline, which is associated with misfolded proteins and inflammation. Early detection and treatment of dementia can be improved by advancements in plasma biomarker detection techniques and technologies like machine learning.
Binswanger disease is the small vessel form of vascular cognitive impairment and dementia. Deposition of Alzheimer disease proteins can begin in midlife and progress slowly, whereas aging of the vasculature also can begin in midlife, continuing to progress into old age, making mixed dementia the most common type of dementia. Biomarkers facilitate the early diagnosis of dementias. It is possible to diagnose mixed dementia before autopsy with biomarkers for vascular disease derived from diffusor tensor images on magnetic resonance imaging and Alzheimer disease proteins, A beta (amyloid beta), and phosphorylated tau, in cerebrospinal fluid or in brain with positron emission tomography. The presence of vascular disease accelerates cognitive decline. Both misfolded proteins and vascular disease promote inflammation, which can be detected in cerebrospinal fluid by the presence of MMPs (matrix metalloproteinases), angiogenic growth factors, and cytokines. MMPs disrupt the blood-brain barrier and break down myelin, producing Binswanger disease's 2 main pathological features. Advances in detecting biomarkers in plasma will provide early detection of dementia and aided by machine learning and artificial intelligence, will enhance diagnosis and form the basis for early treatments.

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