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S3‐03‐03: CSF biomarkers in relation to neuroimaging in mild cognitive impairment and Alzheimer's disease
Author(s) -
Scheltens Philip
Publication year - 2010
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2010.05.384
Subject(s) - dementia , atrophy , medicine , memory clinic , cognitive impairment , neuroimaging , memory impairment , population , alzheimer's disease , psychology , disease , audiology , cognition , psychiatry , environmental health
Background: In the newly proposed research criteria for Alzheimer’s disease patients are defined as having memory dysfunction in addition to either hippocampal atrophy, or abnormal CSF profile. This study applies the criteria in a memory clinic population, using clinical criteria as referent criterion. Methods: 138 AD patients, 145 non demented subjects, 78 patients with other dementias and 91 patients with mild cognitive impairment (MCI) were included. Dichotomized medial temporal lobe atrophy (MTA) score on MRI and dichotomized CSF profiles (based on beta-amyloid1-42, tau and phosphorylated tau at threonine 181 levels) were used in combination with an episodic memory test to assess sensitivity, specificity and likelihood ratios (LR) of the newly proposed criteria and their components separately. Results: We found specificities of 95% and 49% for comparison with non demented subjects and other demented patients respectively, with a sensitivity of 86% for AD. Specificity was highest (100% and 77% respectively, LR+ 1⁄4 48) when both MTA score and CSF profile were abnormal in addition to the episodic memory test, at the cost of a low sensitivity (48%). Conclusions: The newly proposed research criteria for AD yield a good specificity for comparison with non demented subjects. When the type of dementia is clinically doubted, however, at least two supportive features should be considered (i.e. abnormal MTA score and CSF profile) in addition to memory impairment as core diagnostic criterion.