Clinical applicability of diagnostic biomarkers in early-onset cognitive impairment.
Eur J Neurol
; 26(8): 1098-1104, 2019 08.
Article
de En
| MEDLINE
| ID: mdl-30793432
ABSTRACT
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.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Démence frontotemporale
/
Maladie d'Alzheimer
/
Dysfonctionnement cognitif
Type d'étude:
Diagnostic_studies
/
Prognostic_studies
Limites:
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Eur J Neurol
Sujet du journal:
NEUROLOGIA
Année:
2019
Type de document:
Article
Pays d'affiliation:
Espagne