Translation of imaging biomarkers from clinical research to healthcare

  • Ingo Kilimann
  • Jochen René Thyrian
  • Wolfgang Hoffmann
  • Stefan J. Teipel
Beiträge zum Themenschwerpunkt

Abstract

The use of biomarkers for diagnostics of Alzheimer’s disease (AD) has increased over the last years in specialized care and experimental settings. With the possibly upcoming availability of disease-modifying therapeutic agents, the diagnostics and treatment of patients with cognitive impairment will change. Biomarkers will be used as theranostic markers for case finding. The development and evaluation of biomarkers can be framed in a phase model from preclinical studies through trials in expert center settings to the evaluation of biomarkers in primary care, up to testing the efficacy and the impact of biomarkers on the healthcare system. Hippocampal volumetry is the most accepted and in-depth tested biomarker for AD diagnostics and prediction of the course. Therefore, hippocampus volumetry is used to illustrate the phase model of biomarker development and present the milestones already achieved and questions still to be resolved.

Keywords

Alzheimer disease Amyloid Tau Positron emission tomography Cerebrospinal fluid 

Translation bildgebender Biomarker von klinischen Studien bis zur Gesundheitsversorgung

Zusammenfassung

Die Diagnostik der Alzheimer-Krankheit an spezialisierten Zentren hat sich bereits durch die vermehrte Nutzung von Biomarkern verändert. Eine eventuell in den nächsten Jahren bevorstehende Zulassung von krankheitsmodifizierenden Medikamenten zur Behandlung der Alzheimer Krankheit wird den Ablauf der Regeldiagnostik beeinflussen. Biomarker werden dann als wichtiges Theranostikum benötigt. Ein Phasenmodell beschreibt die Entwicklung und Erprobung von Biomarkern von der präklinischen Suche nach möglichen Zielmarkern über wissenschaftliche Untersuchungen in experimentellen Stichproben bis hin zur Erprobung der Effektivität eines Biomarkers in der Primärversorgung. Der bisher am umfangreichsten untersuchte Biomarker zur Diagnostik und Prädiktion des Verlaufs einer Alzheimer-Krankheit ist das Volumen des Hippokampus. Anhand der Hippokampusvolumetrie werden die bereits erreichten Meilensteine aufgezeigt und die noch offenen Fragen bei der Entwicklung von Biomarkern für die Alzheimer-Krankheit dargestellt.

Schlüsselwörter

Morbus Alzheimer Amyloid Tau Positronenemissionstomographie (PET) Zerebrospinalflüssigkeit 

Notes

Compliance with ethical guidelines

Conflict of interests

I. Kilimann, J.R. Thyrian, W. Hoffmann and S.J. Teipel declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

The supplement containing this article is not sponsored by industry.

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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  • Ingo Kilimann
    • 1
    • 2
  • Jochen René Thyrian
    • 1
  • Wolfgang Hoffmann
    • 3
    • 4
  • Stefan J. Teipel
    • 1
    • 2
  1. 1.German Center for Neurodegenerative Disease (DZNE) Rostock/GreifswaldRostockGermany
  2. 2.University Hospital RostockUniversity RostockRostockGermany
  3. 3.Institute for Community MedicineUniversity Hospital GreifswaldGreifswaldGermany
  4. 4.German Center for Neurodegenerative Disease (DZNE) Rostock/GreifswaldGreifswaldGermany

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