This August 2025 podcast from RSNA’s Radiology Journal addresses biomarkers (blood, imaging, and cerebrospinal fluid) 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 included Dr. Kathleen Poston, chief of the movement disorders division at Stanford and co-director of the Lewy Body Dementia Association Research Center of Excellence at Stanford.
The two other speakers were Dr. Sudhir Sivakumaran (chief scientific officer from the Lewy Body Dementia Association) and Dr. Dustin Dunham (GE Healthcare).
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). The speakers expressed the need for collaboration between clinicians, advocacy groups, and industry to advance dementia care.
Here are some excerpts from 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.
[The] urgency is that patients with dementia are increasing in our overall numbers across our aging population. If you think about the number of people who are currently 60 or 65 years and older, and how much that is going to increase over the next 30 years, the urgency is quite palpable. And so that is one of the real drivers is that we need to have therapies that will help individuals who will be affected by dementia to live better lives and to be able to be more independent for longer. And that’ll have a huge impact on healthcare in general and overall in society.
Cerebral spinal fluid-based biomarkers of amyloid and tau have been available for a very long time, but now we have a synuclein CSF biomarker as well that’s highly sensitive and specific to synuclein aggregation in the brain. Ultimately, we want all of these biomarkers to be available in blood so that they can be far more easily accessible to large numbers of individuals. We’re not quite there yet. We have a ways to go to get there, particularly with synuclein, but this huge step forward of at least having a sensitive and specific synuclein biomarker in the cerebral spinal fluid is the first step in making these biomarkers more widely available.
[It’s] important that we have biomarkers across not just amyloid, tau, and synuclein, but other proteins that aggregate in the brain and are responsible for dementia, because many patients have multiple pathologies going on in their brain, and just identifying one or two is actually insufficient to fully understand why someone’s experiencing dementia and to treat it. So we need to not just increase the ways that we can identify these proteins, but also the number of proteins that we can identify.”
(Note: there are a few typos, especially in how the word “Lewy” is transcribed.)