Recent developments in disease modifying therapies have been proven to slow the progression of cognitive decline associated with Alzheimer’s disease. 

And yet, we can only confirm a diagnosis of AD after a patient’s death. 

But what if we could use biomarkers to identify preclinical stage Alzheimer’s and step in long before a patient exhibits dementia? 

On this episode of Inside the Lab, your host, Ms. Kelly Swails, MT(ASCP) introduces us to Dr. Shih-Hsiu Jerry Wang, MD, PhD, Assistant Professor of Pathology and Assistant Professor of Neurology at the Duke University School of Medicine, and shares his talk on emerging biomarkers for the assessment of Alzheimer’s disease from the ASCP 2023 Annual Meeting. 

Dr. Wang explains how we measure AD right now and why there’s discordance between the clinical presentation and pathology of Alzheimer’s. 

Dr. Wang walks us through the core biomarkers for identifying AD per the AT(N) framework, describing the pros and cons of current detection methodologies and offering recommendations around when to use blood biomarkers versus PET imaging or CSF. 

Listen in for insight into the ongoing search for better AD biomarkers and learn what we are doing to diagnose Alzheimer’s in its early stages and intervene accordingly. 

Topics Covered  

· The clinical definition of Alzheimer’s disease and how it impacts cognitive function
· How we measure Alzheimer’s in pathology by amyloid plaques and neurofibrillary tangles
· Why there’s discordance between the clinical presentation and pathology of AD
· The core biomarkers for identifying Alzheimer’s disease per the AT(N) framework
· Identifying the stages of AD based on amyloid plaque, pathologic tau and neurodegeneration
· Examples of PET imaging for the different stages of AD and how imaging biomarkers predict cognitive decline
· The limitations of fluid biomarkers vs. imaging biomarkers to detect Alzheimer's disease
· Some of the emerging ultrasensitive biomarker detection methods in development for AD
· Using cerebral spinal fluids (CSF) vs. plasma biomarkers to identify Alzheimer's disease
· A comparison of the mass spectrometry vs. SIMOA methods of analyzing p-tau biomarkers
· Why Dr. Wang suggests blood biomarkers for AD screening (with confirmation by PET or CSF)
· Why SNAP-25, NfL and GFAP are not considered core biomarkers for Alzheimer’s disease
· The ongoing search for better biomarkers and ultrasensitive detection methods for AD 

Connect with ASCP
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Connect with Dr. Wang
Dr. Wang at Duke University 

Connect with Ms. Swails
Ms. Swails on Twitter

Resources
Dr. Wang’s Slides from the ASCP Annual Meeting 2023
‘NIA-AA Research Framework: Toward a Biological Definition of Alzheimer’s Disease’ in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association
Inside the Lab in the ASCP Store