Title : Determination of blood biomarkers for dynamic monitoring-a promising method for evaluating the effectiveness of alzheimer's disease treatment
Abstract:
Belarusian researchers have developed an algorithm for the clinical and laboratory diagnosis of dementia of various origins, based on the use of clinical indicators and laboratory studies of the concentration of biomarkers of the neurodegenerative process in the blood: β-amyloid (Aß40, Aß42), phosphorylated tau protein (f-tau protein). [Astashonok A. et al., 2023]. The levels of these biomarkers in cerebrospinal fluid and blood were compared, correlations have been identified, the normative values in blood were determined. The minimally invasive method of tau protein and amyloid protein analysis can be widely used both in clinical practice and in research activities. Taking into account the clinical symptoms, standard laboratory data and the level of biomarkers, the patient is prescribed personalized therapy and dynamic monitoring is carried out. The effectiveness of the method is illustrated by a clinical example.
The patient is a male, 74 years old, with decreased memory, household skills, lethargy, and sleep disorders for 2 years. The patient's older brother suffered from dementia. In neurological status, without focal symptoms. Testing showed: MMSE: 16 points – moderate dementia, FAB: 6 points – frontal type dementia. QEEG: diffuse disturbances of cortical rhythm, low-amplitude beta activity prevails, peak alpha frequency is reduced to 8.9 Hz. MRI – grade 1 leukoareosis on the Fasekas scale, 4 points. according to the scale of atrophy of the medial sections of the temporal lobes. The content of neurodegenerative markers in the blood: Aß42 – 18 pg/ml, Aß40 – 14 pg/ml, f-tau protein - 32 pg/ml. According to the results of the examination, dementia in Alzheimer's disease was diagnosed, moderate. A course of cerebrolysin 20 ml intravenously daily No. 20 is prescribed.
After the course of treatment: improvement in dressing, toilet use; MMSE score increased to 17 points; serum Aß42 content is 18 pg/ml, Aß40 - 15 pg/ml, f-tau protein - 29 pg/ml. Changes in the values of neurodegeneration markers in the blood serum during a dynamic examination of the patient showed a complete correlation with a decrease in clinical symptoms. In the future, a minimally invasive method for monitoring the content of f-tau protein and amyloid proteins in the blood can be used not only as a prognostic sign of the development of the pathological process, but also possibly for large-scale screening studies.
