Clinical diagnosis of Alzheimer's disease: recommendations of the International Working Group
Por:
Dubois, B, Villain, N, Frisoni, GB, Rabinovici, GD, Sabbagh, M, Cappa, S, Bejanin, A, Bombois, S, Epelbaum, S, Teichmann, M, Habert, MO, Nordberg, A, Blennow, K, Galasko, D, Stern, Y, Rowe, CC, Salloway, S, Schneider, LS, Cummings, JL, Feldman, HH
Publicada:
1 jun 2021
Ahead of Print:
1 may 2021
Resumen:
In 2018, the US National Institute on Aging and the Alzheimer's Association proposed a purely biological definition of Alzheimer's disease that relies on biomarkers. Although the intended use of this framework was for research purposes, it has engendered debate and challenges regarding its use in everyday clinical practice. For instance, cognitively unimpaired individuals can have biomarker evidence of both amyloid beta and tau pathology but will often not develop clinical manifestations in their lifetime. Furthermore, a positive Alzheimer's disease pattern of biomarkers can be observed in other brain diseases in which Alzheimer's disease pathology is present as a comorbidity. In this Personal View, the International Working Group presents what we consider to be the current limitations of biomarkers in the diagnosis of Alzheimer's disease and, on the basis of this evidence, we propose recommendations for how biomarkers should and should not be used for diagnosing Alzheimer's disease in a clinical setting. We recommend that Alzheimer's disease diagnosis be restricted to people who have positive biomarkers together with specific Alzheimer's disease phenotypes, whereas biomarker-positive cognitively unimpaired individuals should be considered only at-risk for progression to Alzheimer's disease.
Filiaciones:
Dubois, B:
Sorbonne Univ, AP HP, Dept Neurol, Paris, France
Sorbonne Univ, Inst Cerveau, Paris, France
Villain, N:
Sorbonne Univ, AP HP, Dept Neurol, Paris, France
Sorbonne Univ, Inst Cerveau, Paris, France
Frisoni, GB:
Univ Geneva, Lab Neuroimaging Aging LANVIE, Geneva, Switzerland
Univ Hosp Geneva, Memory Clin, Geneva, Switzerland
St John God Clin Res Ctr, Lab Alzheimers Neuroimaging & Epidemiol LANE, Brescia, Italy
Rabinovici, GD:
Univ Calif San Francisco, Dept Neurol, Memory & Aging Ctr, San Francisco, CA USA
Univ Calif San Francisco, Dept Radiol & Biomed Imaging, San Francisco, CA 94143 USA
Sabbagh, M:
Cleveland Clin, Lou Ruvo Ctr Brain Hlth, Las Vegas, NV USA
Cappa, S:
Univ Sch Adv Studies, Pavia, Italy
RCCS Mondino Fdn, Pavia, Italy
Bejanin, A:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Neurol, St Pau Memory Unit, Barcelona, Spain
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Biomed Res Inst, Barcelona, Spain
Network Ctr Biomed Res Neurodegenerat Dis CIBERNE, Madrid, Spain
Bombois, S:
Sorbonne Univ, AP HP, Dept Neurol, Paris, France
Univ Lille, U1171 Degenerat & Vasc Cognit Disorders, CHU Lille, INSERM, Lille, France
Epelbaum, S:
Sorbonne Univ, AP HP, Dept Neurol, Paris, France
Sorbonne Univ, Inria APHP Collaborat, Inria ARAMIS Projectteam, Paris, France
Sorbonne Univ, Inst Cerveau, Paris, France
Teichmann, M:
Sorbonne Univ, AP HP, Dept Neurol, Paris, France
Habert, MO:
Sorbonne Univ, AP HP, Dept Nucl Med, Paris, France
Sorbonne Univ, Lab Imagerie Biomed, INSERM, CNRS, Paris, France
Sorbonne Univ, Inst Cerveau, Paris, France
Nordberg, A:
Karolinska Inst, Ctr Alzheimer Res, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden
Karolinska Univ Hosp, Aging Brain, Theme Aging, Stockholm, Sweden
Blennow, K:
Univ Gothenburg, Inst Neurosci & Physiol, Dept Psychiat & Neurochem, Sahlgrenska Acad, Molndal, Sweden
Sahlgrens Univ Hosp, Clin Neurochem Lab, Molndal, Sweden
Galasko, D:
Univ Calif San Diego, Dept Neurosci, La Jolla, CA 92093 USA
Stern, Y:
Columbia Univ, Dept Neurol, Cognit Neurosci Div, New York, NY USA
Rowe, CC:
Univ Melbourne, Dept Mol Imaging & Therapy, Austin Hlth, Melbourne, Vic, Australia
Salloway, S:
Brown Univ, Alpert Med Sch, Dept Neurol, Providence, RI 02912 USA
Brown Univ, Alpert Med Sch, Dept Psychiat, Providence, RI 02912 USA
Butler Hosp, Providence, RI 02906 USA
Schneider, LS:
Univ Southern Calif, Keck Sch Med, Los Angeles, CA 90007 USA
Cummings, JL:
Cleveland Clin, Lou Ruvo Ctr Brain Hlth, Las Vegas, NV USA
Univ Nevada, Sch Integrated Hlth Sci, Dept Brain Hlth, Chambers Grundy Ctr Transformat Neurosci, Las Vegas, NV 89154 USA
Feldman, HH:
Univ Calif San Diego, Dept Neurosci, La Jolla, CA 92093 USA
Univ Calif San Diego, Shiley Marcos Alzheimers Dis Res Ctr, La Jolla, CA 92093 USA
Univ Calif San Diego, Alzheimer Dis Cooperat Study, La Jolla, CA 92093 USA
Green Submitted, Bronze
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