Hopkins team spotlights biomarkers ratio that tags presymptomatic Alzheimer's

Marilyn Albert, professor of neurology, Johns Hopkins University

Researchers at Johns Hopkins say they've been able to track a pair of biomarkers that can shed light on a patient's risk of developing Alzheimer's and pinpoint the disease before telltale symptoms appear.

Using cerebral spinal fluid tapped from initially healthy but high-risk patients--many with a history of the disease in their families--over a period of 10 years, the Johns Hopkins team found an intriguing correlation between the rise and fall of phosphorylated tau and beta amyloid in the fluid. A particular baseline ratio of the two proteins could be used as a harbinger of mild cognitive impairment, which can be a precursor to Alzheimer's. And the more tau and the less beta amyloid found in the fluid over time could also be predictive of presymptomatic Alzheimer's.

Tau and beta amyloid are already considered the two primary culprits behind Alzheimer's, though there is no solid consensus yet on just what causes the rapid erosion of memory that characterizes the disease, which afflicts millions of people around the world. Gaining insights into biomarkers that can allow investigators to accurately select patients at a very early stage of the disease can be invaluable for companies trying to develop new therapies that can slow or stop disease progression before it does serious damage to the brain.

"When we see patients with high blood pressure and high cholesterol, we don't say we will wait to treat you until you get congestive heart failure. Early treatments keep heart disease patients from getting worse, and it's possible the same may be true for those with presymptomatic Alzheimer's," says Marilyn Albert, a professor of neurology at the Johns Hopkins University School of Medicine. She is the primary investigator of the study, results of which are published in the Oct. 16 issue of the journal Neurology. "But it has been hard to see Alzheimer's disease coming, even though we believe it begins developing in the brain a decade or more before the onset of symptoms.

"We wondered if we could measure something in the cerebral spinal fluid when people are cognitively normal to give us some idea of when they will develop difficulty," Albert adds. "The answer is yes."

- here's the press release from Johns Hopkins
- and the research abstract