This August 12, 2025 podcast from RSNA’s Radiology Journal addresses biomarkers (blood, imaging, and CSF) for Lewy body dementia and other dementias. While the audience for the podcast is healthcare professionals, the content may be of interest to our lay community. The speakers were Dr. Kathleen Poston (chief of the movement disorders division at Stanford), Dr. Sudhir Sivakumaran (chief scientific officer from the Lewy Body Dementia Association), and Dr. Dustin Dunham (GE Healthcare). The speakers expressed the need for collaboration between clinicians, advocacy groups, and industry to advance dementia care.
Many goals were discussed, including being able to use biomarkers to get the right patients in interventional clinical trials, and being able to identify all proteins in the brain (not just amyloid, tau, and synuclein).
Here are a couple of excerpts:
Dr. Poston: [With] the advent of biologically-specified biomarkers, both in blood as well as in imaging, we now can identify the molecular pathologies associated with each of these dementias, and really be far more precise in telling patients what it is they’re experiencing. The great part about that is that this ability has also spearheaded interventional clinical trials, because you can’t have a drug developed to really molecularly target a disease if you can’t even identify the people who have that particular biology. So this combination of being able to identify the right patients and the just explosion of research that’s gone into interventions has brought us to a point where now we are starting to be able to identify the right patient and then have a clinical intervention that can potentially slow that progression of disease. So this is just a huge change for our field compared to how we treated dementias for the last decades.
Dr. Dunham: [Biomarkers are used in] clinical trials to help identify and recruit individuals likely to have the specific pathology of interest being targeted by the investigational treatment, and that can help improve the rigor and success rate of trials. Biomarkers can track changes in the underlying pathology, like amyloid clearance in response to anti-amyloid therapies to determine if a treatment is having its intended biological effect. From a safety perspective, biomarkers can be used to monitor for potential side effects of treatments, such as amyloid-related imaging abnormalities, or ARIA, associated with certain Alzheimer drugs. They can also be utilized to optimize trial design. Biomarker data can potentially reduce the required sample size for trials and help identify appropriate dosages or endpoints. And then I think in the future, biomarkers are expected to play a crucial role in personalizing treatment approaches and monitoring patients receiving specific therapies.
Dr. Sivakumaran: “These diseases are notoriously heterogeneous, both clinically and biologically. So with that level of heterogeneity and the fact that [Lewy] body dementia, for example, has a significant and a huge amount of overlap with Alzheimer’s or Parkinson’s and the prevalence of mixed pathology, it’s important to also consider as we go forward to look at multi-modal biomarkers and how each of them perform individually, but also in combination with others to help better characterize the mechanisms underlying the disease progression and tracking changes over time.
We, at Brain Support Network, would like to remind everyone that the only way to validate a biomarker is through brain donation! Reach out to us at Brain Support Network for information about brain donation for neurodegenerative disorders.