Скачать или смотреть Pathway to Preventing Neurodegenerative Diseases | Neurology Grand Rounds

Recorded live on December 13th, 2024

In this recorded Neurology Grand Rounds presentation, Vice Chair of Neurology Research and Director of the Parkinson’s Foundation Center of Excellence & Professor in Neurology & Neurological Sciences at Stanford University, Dr. Kathleen Poston, presents a forward-looking vision of biomarker-driven diagnosis and prevention in neurodegenerative diseases, particularly Parkinson’s disease (PD) and Lewy body dementia (LBD). Dr. Poston discusses the paradigm shift of moving from syndrome-based to biological definitions of neurodegenerative diseases to enable secondary prevention—identifying individuals with biomarker evidence of disease before symptoms develop. She also reviews biomarker advances such as
Alpha-synuclein Seed Amplification Assay (SAA) and skin biopsy immunofluorescence can now reliably detect Lewy body pathology in living patients. Dr. Poston explains how these tools differentiate between PD, LBD, and multiple system atrophy (MSA), with strong concordance to pathology. She then reviews potential clinical implications such as how SAA is highly specific and how early biomarkers often precede changes in dopamine imaging, suggesting a long preclinical window for intervention.
She then moves on to address integrated staging: a proposed research framework that classifies individuals from asymptomatic (biomarker-positive) to mild symptoms to full clinical syndromes, aiming to support trials in pre-symptomatic or early-symptomatic stages. She concludes her lecture by expressing the need for quantitative, non-invasive, and widely accessible biomarkers, the importance of diverse population validation, integration of multi-pathology biomarker profiles (e.g., synuclein, tau, amyloid) for personalized risk assessment and trial design and emphasizing that while clinical use is premature, the tools and data now exist to meaningfully pursue early detection and eventual prevention of neurodegenerative disease.

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Learning Objectives:
1. Discuss the need for quantitative, non-invasive, and widely accessible biomarkers.
2. Identify the importance of diverse population validation, integration of multi-pathology biomarker profiles for personalized risk assessment and trial design.
3. Review tools and data that now exist to meaningfully pursue early detection and eventual prevention of neurodegenerative disease.

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