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P1‐376: ARE NEUROIMAGING BIOMARKERS USEFUL TO DIAGNOSE PRODROMAL AD IN CLINICAL PRACTICE? EXPERIENCE AT A TERTIARY CLINIC
Author(s) -
Echeveste Beatriz,
Recio Miriam,
Imaz Laura,
Garcia de Eulate Reyes,
Arbizu Javier,
Riverol Mario
Publication year - 2018
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.2018.06.384
Subject(s) - dementia , neuroimaging , medicine , biomarker , demographics , neurodegeneration , memory clinic , oncology , disease , pediatrics , psychiatry , biochemistry , chemistry , demography , sociology
Background:Preclinical, prodromal and dementia. In the prodromal phase, a clinical diagnosis of mild cognitive impairment (MCI) can be stablished. However, not all subjects withMCI have a prodromal AD. Distinct groups have proposed classifications that incorporate biomarkers to better diagnose this early AD phase. We wanted to determinate the utility of the IWG-2 and NIA-AA classifications using neuroimaging biomarkers in the clinical practice, and their impact on the conversion to dementia. Methods: We selected 96 MCI patients from our Memory Clinic. We excluded subjects older than 85 and those with structural brain lesion. Participants went through an amyloid PET scan and an imaging biomarker of neurodegeneration (brain MRI and/or FDG-PET scan). All subjects were classified as amyloid or neurodegeneration positive or negative, and then we apply NIA-AA and IWG-2 classifications. Patients were followed to record the conversion to dementia. Statistical analyses were done with SPSS version 20.0 with significance set at P<0.05. All analyses were adjusted by age, gender and education. Results: Demographics are shown on table 1.According to the IWG-2, 54 patients had prodromal AD and 42 patients had non-prodromal AD. According to the NIA-AA, 26 patients were at low, 39 at high, 16 at IAP and 15 at SNAP group. Seventy-four patients were followed at least for 6 months (media time 24.9 months). Twenty-eight patients converted to dementia (29.22%); 22 of them had a diagnosis of dementia due to AD (all amyloid positive). According to the NIA-AA classification, 15 were at High AD likelihood group and 7 at IAP group. Six patients converted to non-AD dementia, 2 were at the low AD likelihood group and 4 corresponded to the SNAP group, (all amyloid negative). Three MCI patients reverted to normal cognition; they were at the low AD likelihood group. Pet and conversion results are shown on tables 2 and 3. Conclusions: IWG-2 classification is easier to apply. NIAAA classification may be more complete, but it concerns more difficulties at daily work. A positive amyloid PETwas more frequent