Titolo della tesi: Approaching the early stages of Alzheimer's Disease: evaluating the relationship with telomere length shortening and the diagnostic potential of Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (Angio-OCT)
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the most common form of dementia. In recent years, thanks to the development of specific biomarkers that identify the molecular pathology of AD, it has become clear that AD dementia is a chronic condition that develops silently for more than 10 years before the onset of the first symptoms. The pathological-clinical “continuum of AD” encompasses the time between the initial neuropathological changes and symptoms of advanced disease. Timely detection of the disease would therefore recognize patients that are at risk for future cognitive deterioration and provide a time window for prevention and novel therapeutic interventions.
The scopes of this thesis are focused on the evaluation of the role of telomere length, which has been proposed as a candidate biomarker of aging, on AD development, analyzing leukocyte telomere length (LTL) in a sample of Mild cognitive impairment (MCI) and AD patients compared to healthy controls, with cross-sectional and longitudinal analyses (1-year follow-up), observing that LTL may in some way influence the clinical course of patients with AD and suggesting that shorter LTL is associated with worse progression of AD (Study I).
Moreover, we evaluated the diagnostic potential of Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA), in the prodromal phases of AD, observing changes in retinal layer thickness and volumes compared to healthy controls but only poor relationship with cognitive functioning (Study II) and analyzing the characteristics of the retinal and choriocapillaris vascular structure, founding only a significant reduction in the flow area of choriocapillaris in patients with early AD versus the age-matched control group (Study III).
In general, the results of these studies invite further clinical validation of other biomarkers in the context of early AD diagnosis, prognosis, and treatment monitoring in individual patients.