Juggling Alzheimer Biomarkers and Their Various Roles: Sharon Cohen, MD, FRCPC

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"There’s a lot of discussion about, ‘Is amyloid lowering enough for us to predict clinical benefit?’ For example, do we need to see a tau biomarker decline either on PET scan, or in one of the isoforms in plasma or spinal fluid that measure tau? It’s very complicated. Then there are markers of neurodegeneration that are not specific to Alzheimer but give us a take on how much brain cell loss there is."

Alzheimer disease (AD), a neurodegenerative disorder that progressively compromises cognition, function, and behavior, is reliant on the use of biomarkers, which have become a major focus in recent years. These biomarkers can help characterize a baseline state, a disease process, or response to treatment. Biomarkers include measures of genes, omics technologies, imaging, blood, electrocardiograms, or evaluations of organ function.

Despite the boom of these markers within the AD field, a lot of discussion is centered around which of them hold the most clinical value and whether certain combinations of biomarkers contain even greater potential. Developments in non-invasive retinal imaging technologies, such as RetiSpec, have provided a means to study neuronal and vascular structures in the retina in people with AD. In a validation study, RetiSpec’s hyperspectral retinal imaging was effective in predicting brain amyloid-ß status in individuals at risk for AD when compared with clinical gold standard approaches.

Lead author of that study, Sharon Cohen, MD, FRCPC, believes there are individual roles for certain biomarkers, with some more suited for different clinical settings. Cohen, neurologist and assistant professor at the University of Toronto, sat down to discuss the ongoing conversation of AD biomarkers, and whether tools like RetiSpec will change how clinicians view the importance of retinal imaging.