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  • Neurodegenerative disease can cause different symptoms, due to the different region of degradation

Alzheimer's disease

Alzheimer’s disease (AD) is defined by brain deposition of numerous amyloid plaques and neurofibrillary tangles. - Mainly due to two type of disordered misfolded proteins - Tau: neurofibrillary - Amyloid plaques (Amyloid $\beta, A\beta$) - Symptoms: - Memory loss - Disorientation in time and space - Difficulty in interpreting images and distances - Poor judgement - Lack of engagement at work and social activities - Problems in oral and written expression - Changes of humor and personality - Also contains varaible clinical subtypes: - Memory syndrome: typical AD - Language syndrome: logogenic variant of AD - Visual syndrome: Posterior variant of AD - Frontal syndrome: frontal varaint of AD

  • Phases of amyloid-$\beta$ deposition in AD

    • no AD or non-AD dementia --> pre_AD dementia --> symptomatic AD
  • ==Braak stages==

Tau: microtubule-associated protein

  • there are six isoforms of tau
  • The formation of tau neurofibrillary tangels
    • Tau 主要和磷酸化有关,会导致microtubule的聚集

AD's biomarkers

1. PET: Positron emission
  • PET is a non-invasive imaging tech

  • using radioactive compounds that bind fibrillary Aβ or tau.

2. Cerebrospinal Fluid (CSF) biomarkers

CSF is collected via lumbar puncture and provides direct insight into brain biochemistry:

  • Amyloid-β42: Decreases in CSF as it accumulates in brain plaques
  • Total tau and phosphorylated tau: Increase with neuronal damage and tangle formation
  • Aβ42/Aβ40 ratio: Improves diagnostic accuracy over Aβ42 alone
  • Neurofilament light chain (NfL): Indicates neuronal damage (though not specific to AD)
3. Blood biomarkers

Recent advances have enabled less invasive blood tests:

  • Plasma p-tau181 and p-tau217: Highly specific for AD pathology
  • Plasma Aβ42/Aβ40 ratio: Correlates with brain amyloid burden
  • Plasma NfL: Reflects neurodegeneration but isn't AD-specific
  • GFAP (Glial Fibrillary Acidic Protein): Indicates astrocytic activation