Plasma biomarkers in neuropsychiatric syndromes: A narrative review

Neuropsychiatric symptoms (NPS) are common features of neurodegenerative disease (NDD) but are relatively understudied compared to cognition, especially regarding biomarkers. Further, emerging evidence describes the utility of systematic assessment of NPS across the cognitive continuum, even in advance of dementia. In this narrative review, we discuss the role of plasma biomarkers in relation to NPS across the cognitive continuum of unimpaired, subjective cognitive decline, mild cognitive impairment, and dementia. While Alzheimer's disease is the primary focus, vascular, Lewy body, and frontotemporal dementia etiologies are also discussed. Literature searches included NPS and dementia-related search terms with additional literature identified based on the author group's subject area expertise. We found that plasma biomarkers are a burgeoning field, and scalability and accessibility make them well-suited for the study of NPS across the disease continuum. In early-stage NDD, diagnostic biomarkers are best suited for discriminating NDD-related NPS from non-NDD psychiatric syndromes and/or NPS due to other causes. In those with dementia, monitoring and prognostic biomarkers may enable the assessment of treatment response or help predict the risk of worsening symptoms. We conclude that plasma amyloid-β and tau show great promise in assessing NPS, especially during early-stage disease, but inflammatory and genetic biomarkers may also play a role across the disease course. Systematic research is required, keeping in mind the ethical considerations of knowing biomarker status in early-stage disease.

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Publication Details

Journal
Journal of Alzheimer s Disease
Published
2025-11-24
DOI
https://doi.org/10.1177/13872877251392185
Primary Topic
Dementia and Cognitive Impairment Research
Type
article
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article

Plasma biomarkers in neuropsychiatric syndromes: A narrative review

Krushnaa Sankhe, Zahinoor Ismail, Moyra E. Mortby, Fabricio Ferreira de Oliveira et al.
Journal of Alzheimer s Disease
Dementia and Cognitive Impairment Research
article

Plasma biomarkers in neuropsychiatric syndromes: A narrative review

Krushnaa Sankhe, Zahinoor Ismail, Moyra E. Mortby, Fabricio Ferreira de Oliveira, Ganesh Muneshwar Babulal, Chinedu Udeh‐Momoh, Corinne E. Fischer, Dylan X. Guan, Marc Cantillon, Miriam Rabl, Jennifer R. Gatchel, Maryam Ghahremani, James R. Bateman, Krista L. Lanctôt, Rawan Tarawneh, Fabrizia D’Antonio, José Guerrero‐Cantera, Arturo X. Pereiro, George Perry, Hillary J Rouse, Suzanne E. Schindler, Byron Creese, Michelle M. Mielke, Oriel J. Feldman, Ana C. Pereira, William Z. Potter, Ramit Ravona-Springer, Allyson Rosen
article en

Abstract

Neuropsychiatric symptoms (NPS) are common features of neurodegenerative disease (NDD) but are relatively understudied compared to cognition, especially regarding biomarkers. Further, emerging evidence describes the utility of systematic assessment of NPS across the cognitive continuum, even in advance of dementia. In this narrative review, we discuss the role of plasma biomarkers in relation to NPS across the cognitive continuum of unimpaired, subjective cognitive decline, mild cognitive impairment, and dementia. While Alzheimer's disease is the primary focus, vascular, Lewy body, and frontotemporal dementia etiologies are also discussed. Literature searches included NPS and dementia-related search terms with additional literature identified based on the author group's subject area expertise. We found that plasma biomarkers are a burgeoning field, and scalability and accessibility make them well-suited for the study of NPS across the disease continuum. In early-stage NDD, diagnostic biomarkers are best suited for discriminating NDD-related NPS from non-NDD psychiatric syndromes and/or NPS due to other causes. In those with dementia, monitoring and prognostic biomarkers may enable the assessment of treatment response or help predict the risk of worsening symptoms. We conclude that plasma amyloid-β and tau show great promise in assessing NPS, especially during early-stage disease, but inflammatory and genetic biomarkers may also play a role across the disease course. Systematic research is required, keeping in mind the ethical considerations of knowing biomarker status in early-stage disease.

Journal of Alzheimer s DiseaseVol. 109(1)
University of London (GB), St. Michael's Hospital (CA), Sunnybrook Health Science Centre (CA), Harvard University (US), Tel Aviv University (IL), Mexican Social Security Institute (MX), University of Calgary (CA), University of Toronto (CA), Universidade de Santiago de Compostela (ES), Washington University in St. Louis (US), University of Exeter (GB), University of Johannesburg (ZA), University of South Florida (US), Sheba Medical Center (IL), McLean Hospital (US), Johnson University (US), Karolinska Institutet (SE), UNSW Sydney (AU), Massachusetts General Hospital (US), University Hospital of Zurich (CH), Aga Khan University Nairobi (KE), Fondazione Santa Lucia (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Sunnybrook Research Institute, Hotchkiss Brain Institute (CA), The University of Texas at San Antonio (US), Wake Forest University (US), Saint Louis University (US), Brunel University of London (GB), Neuroscience Research Australia (AU), Sapienza University of Rome (IT), Universidade Federal de São Paulo (BR), University of Sheffield (GB), Stanford University (US), Icahn School of Medicine at Mount Sinai (US)
Openalex Percentile: Top 57%
Dementia and Cognitive Impairment Research
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