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Advanced Neurology BRRS: A screening and monitoring tool for better prognosis in AD

highly selected brain regions that are primarily impaired Writing – original draft: Qiujie Shan and Ping-Hsuan Wei
in AD-spectrum patients, including the hippocampus, Writing – review & editing: Feng Bai and Yun Xu
medial temporal lobe, precuneus, and temporoparietal
regions . Nevertheless, despite the fact that there are Ethics approval and consent to participate
[44]
extensive studies on respective AD risk factors, the Not applicable.
scarcity in comprehensive research focusing on the
weight of the impact of each AD risk factor until recently Consent for publication
makes it impractical for further discussions in this review, Not applicable.
requiring further research to solve this in the future. In
addition, although the BRRS can provide diagnostic Availability of data
and therapeutic guidance based on the patients’ clinical
performance, individual AD development rate cannot Not applicable.
be evaluated in the early stage of application but only by References
means of accumulated data from the patients’ total scores.
Last but not least, neuropsychological testing, which 1. Aisen PS, Jimenez-Maggiora GA, Rafii MS, et al., 2022,
we suggest to employ in conjunction with BRRS, is not Early-stage alzheimer disease: getting trial-ready. Nat Rev
included due to our consideration that it has already been Neurol, 18(7): 389–399.
widely used in clinical staging. https://doi.org/10.1038/s41582-022-00645-6

5. Conclusions 2. Vermunt L, Sikkes SAM, van den Hout A, et al., 2019,
Duration of preclinical, prodromal, and dementia stages
In this review, we propose the BRRS, a promising of alzheimer’s disease in relation to age, sex, and APOE
preliminary screening and monitoring tool based on AD genotype. Alzheimers Dement, 15(7): 888–898.
risk factors and brain alteration, which can be used in https://doi.org/10.1016/j.jalz.2019.04.001
parallel with the current AD guideline, with individual 3. Studart AN, Nitrini R, 2016, Subjective cognitive decline:
differences fully considered and little additional burden The first clinical manifestation of alzheimer’s disease?
added. Due to its simplicity of use, the BRRS is accessible to Dement Neuropsychol, 10(3): 170–177.
clinicians in grassroots clinics and can be widely promoted.
It has major diagnostic and therapeutic implications as https://doi.org/10.1590/s1980-5764-2016dn1003002
it significantly contributes to realizing early and accurate 4. Rabin LA, Smart CM, Amariglio RE, 2017, Subjective
identification of AD, the tracking and prognosis of cognitive decline in preclinical alzheimer’s disease. Annu
AD-spectrum patients, as well as the design of individually Rev Clin Psychol, 13: 369–396.
tailored treatment in a timely manner. Furthermore, we https://doi.org/10.1146/annurev-clinpsy-032816-045136
strongly recommend that the weight coefficient of each 5. Ferreira D, Pereira JB, Volpe G, et al., 2019, Subtypes of
item in BRRS be extensively studied in future research for alzheimer’s disease display distinct network abnormalities
the sake of a precise and formal application of the scale in extending beyond their pattern of brain atrophy. Front
clinical settings as soon as possible. Neurol, 10: 524.
Acknowledgments https://doi.org/10.3389/fneur.2019.00524

None. 6. Lehmann M, Madison C, Ghosh PM, et al., 2015, Loss of
functional connectivity is greater outside the default mode
Funding network in nonfamilial early-onset alzheimer’s disease
variants. Neurobiol Aging, 36(10): 2678–2686.
This work was partly supported by grants from the National https://doi.org/10.1016/j.neurobiolaging.2015.06.029
Natural Science Foundation of China (No. 82071186;
81822013). 7. Vogel JW, Hansson O, 2022, Subtypes of alzheimer’s disease:
questions, controversy, and meaning. Trends Neurosci, 45(5):
Conflict of interest 342–345.

The authors declare that they have no competing interests. https://doi.org/10.1016/j.tins.2022.02.001
8. Duara R, Barker W, 2022, Heterogeneity in alzheimer’s
Author contributions disease diagnosis and progression rates: Implications for

Conceptualization: Ping-Hsuan Wei and Qiujie Shan therapeutic trials. Neurotherapeutics, 19(1): 8–25.
Supervision: Feng Bai and Yun Xu https://doi.org/10.1007/s13311-022-01185-z

Volume 1 Issue 3 (2022) 8 https://doi.org/10.36922/an.v1i3.208