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Clinical applicability of diagnostic biomarkers in early‐onset cognitive impairment
Author(s) -
Falgàs N.,
TortMerino A.,
Balasa M.,
BorregoÉcija S.,
Castellví M.,
Olives J.,
Bosch B.,
FérnandezVillullas G.,
Antonell A.,
Augé J. M.,
Lomeña F.,
Perissinotti A.,
Bargalló N.,
SánchezValle R.,
Lladó A.
Publication year - 2019
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13945
Subject(s) - medicine , cognitive impairment , cognition , intensive care medicine , psychiatry
Background and purpose Several diagnostic biomarkers are currently available for clinical use in early‐onset cognitive impairment. The decision on which biomarker is used in each patient depends on several factors such as its predictive value or tolerability. Methods There were a total of 40 subjects with early‐onset cognitive complaints (<65 years of age): 26 with Alzheimer's disease ( AD ), five with frontotemporal dementia and nine with diagnostic suspicion of non‐neurodegenerative disorder. Clinical and neuropsychological evaluation, lumbar puncture for cerebrospinal fluid ( CSF ) AD core biochemical marker determination, medial temporal atrophy evaluation on magnetic resonance imaging, amyloid‐positron emission tomography ( PET ) and 18 F‐fluorodeoxyglucose‐ PET were performed. Neurologists provided pre‐ and post‐biomarker diagnosis, together with diagnostic confidence and clinical/therapeutic management. Patients scored the tolerability of each procedure. Results Cerebrospinal fluid biomarkers and amyloid‐ PET increased diagnostic confidence in AD (77.4%–86.2% after CSF , 92.4% after amyloid‐ PET , P < 0.01) and non‐neurodegenerative conditions (53.6%–75% after CSF , 95% after amyloid‐ PET , P < 0.05). Biomarker results led to diagnostic (32.5%) and treatment (32.5%) changes. All tests were well tolerated. Conclusions Biomarker procedures are well tolerated and have an important diagnostic/therapeutic impact on early‐onset cognitive impairment.