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当代阿耳茨海默病研究

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ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

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Research Article

临床实践中不确定的脑脊液生物标志物后PET淀粉样蛋白。有必要重复手续吗?

卷 17, 期 8, 2020

页: [698 - 708] 页: 11

弟呕挨: 10.2174/1567205017666201109092637

价格: $65

摘要

介绍：在体内阿尔茨海默病(AD)诊断缺乏金标准的情况下，AD生物标志物，如脑脊液生物标志物(CSF-B)和宠物淀粉样蛋白被认为在临床实践指南中具有诊断价值，并具有双方同意的适当使用标准(AUC)。然而，很少有证据表明它们在临床环境中的应用或不匹配结果的方法。这项工作的目的是评估AD生物标志物在临床实践中的应用，重点是PET -淀粉样蛋白在不确定的CSF-B病例中的应用。 方法：这个自然的，有争议的病例系列包括了满足CSF-B和PET-淀粉样蛋白AUC的患者，其CSF-B结果是不诊断的(目标人群)，分析诊断的确定性，治疗方法，以及CSF-B和PET-淀粉样蛋白结果之间的关系。 结果：在2373名符合条件的患者中，417名(17.6%)患者研究了AD生物标志物，最常见的原因是65岁以下的认知障碍，311名患者使用CSF-B, 150名患者使用PET -淀粉样蛋白。CSF-B结果对44例患者无诊断意义(52.3%男性;年龄60.9±6.6岁)，然后接受了宠物淀粉样蛋白研究，31例阳性。CSF-B与PET -淀粉样蛋白之间的k系数为0.108(54.5%一致性)。在多元回归分析中，Aβ42是PET -淀粉样蛋白阳性的唯一显著预测因子(p= 0.018)。在目标人群中，PETA-淀粉样蛋白增加了53.7%的诊断可信度(p <0.001)，并在36.4%的病例中改进了治疗方法。 结论：这些发现支持AD生物标志物的重复，并证明PET-淀粉样蛋白的实施提供了早期和确定的诊断，指导适当的治疗。

关键词: 轻度认知障碍，阿尔茨海默病，阿尔茨海默病生物标记物，阿尔茨海默病诊断成像，阿尔茨海默病脑脊液，淀粉样正电子发射断层扫描，适当的使用标准，临床应用。

« Previous Next »
[1]
Alzheimer's Association. 2016 Alzheimer’s disease facts and figures. Alzheimers Dement 2016; 12(4): 459-509.
[http://dx.doi.org/10.1016/j.jalz.2016.03.001] [PMID: 27570871]
[2]
McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7(3): 263-9.
[http://dx.doi.org/10.1016/j.jalz.2011.03.005] [PMID: 21514250]
[3]
Beach TG, Monsell SE, Phillips LE, Kukull W. Accuracy of the clinical diagnosis of Alzheimer disease at National Institute on Aging Alzheimer Disease Centers, 2005-2010. J Neuropathol Exp Neurol 2012; 71(4): 266-73.
[http://dx.doi.org/10.1097/NEN.0b013e31824b211b] [PMID: 22437338]
[4]
Blennow K, Dubois B, Fagan AM, Lewczuk P, de Leon MJ, Hampel H. Clinical utility of cerebrospinal fluid biomarkers in the diagnosis of early Alzheimer’s disease. Alzheimers Dement 2015; 11(1): 58-69.
[http://dx.doi.org/10.1016/j.jalz.2014.02.004] [PMID: 24795085]
[5]
Atri A. The Alzheimer’s disease clinical spectrum diagnosis and management. Med Clin North Am 2019; 103(2): 263-93.
[http://dx.doi.org/10.1016/j.mcna.2018.10.009] [PMID: 30704681]
[6]
Jack CR Jr, Bennett DA, Blennow K, et al. Contributors. NIA-AA Research Framework: Toward a biological definition of Alzheimer’s disease. Alzheimers Dement 2018; 14(4): 535-62.
[http://dx.doi.org/10.1016/j.jalz.2018.02.018] [PMID: 29653606]
[7]
Jack CR Jr, Bennett DA, Blennow K, et al. A/T/N: An unbiased descriptive classification scheme for Alzheimer disease biomarkers. Neurology 2016; 87(5): 539-47.
[http://dx.doi.org/10.1212/WNL.0000000000002923] [PMID: 27371494]
[8]
Johnson KA, Minoshima S, Bohnen NI, et al. Alzheimer’s association, society of nuclear medicine and molecular imaging, amyloid imaging taskforce. Appropriate use criteria for amyloid PET: A report of the amyloid imaging task force, the society of nuclear medicine and molecular imaging, and the Alzheimer’s association. Alzheimers Dement 2013; 9: e-1-e-16.
[http://dx.doi.org/10.1016/j.jalz.2013.01.002]
[9]
Hornberger J, Bae J, Watson I, Johnston J, Happich M. Clinical and cost implications of amyloid beta detection with amyloid beta positron emission tomography imaging in early Alzheimer’s disease - the case of florbetapir. Curr Med Res Opin 2017; 33(4): 675-85.
[http://dx.doi.org/10.1080/03007995.2016.1277197] [PMID: 28035842]
[10]
Hansson O, Mikulskis A, Fagan AM, et al. The impact of preanalytical variables on measuring cerebrospinal fluid biomarkers for Alzheimer’s disease diagnosis: A review. Alzheimers Dement 2018; 14(10): 1313-33.
[http://dx.doi.org/10.1016/j.jalz.2018.05.008] [PMID: 29940161]
[11]
Engelborghs S, Niemantsverdriet E, Struyfs H, et al. Consensus guidelines for lumbar puncture in patients with neurological diseases. Alzheimers Dement (Amst) 2017; 8: 111-26.
[http://dx.doi.org/10.1016/j.dadm.2017.04.007] [PMID: 28603768]
[12]
Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: The IWG-2 criteria. Lancet Neurol 2014; 13(6): 614-29.
[http://dx.doi.org/10.1016/S1474-4422(14)70090-0] [PMID: 24849862]
[13]
Shaw LM, Arias J, Blennow K, et al. Appropriate use criteria for lumbar puncture and cerebrospinal fluid testing in the diagnosis of Alzheimer’s disease. Alzheimers Dement 2018; 14(11): 1505-21.
[http://dx.doi.org/10.1016/j.jalz.2018.07.220] [PMID: 30316776]
[14]
Ceccaldi M, Jonveaux T, Verger A, et al. NEUUS in AD study group. Added value of 18F-florbetaben amyloid PET in the diagnostic workup of most complex patients with dementia in France: A naturalistic study. Alzheimers Dement 2018; 14(3): 293-305.
[http://dx.doi.org/10.1016/j.jalz.2017.09.009] [PMID: 29107051]
[15]
Triviño-Ibáñez EM, Sánchez-Vañó R, Sopena-Novales P, et al. Impact of amyloid-PET in daily clinical management of patients with cognitive impairment fulfilling appropriate use criteria. Medicine (Baltimore) 2019; 98(29)e16509
[http://dx.doi.org/10.1097/MD.0000000000016509] [PMID: 31335725]
[16]
(a)Martínez G, Vernooij RWM, Fuentes Padilla P, Zamora J, Flicker L, Bonfill Cosp X. 18F PET with flutemetamol for the early diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2017; (11): CD012884
[http://dx.doi.org/10.1002/14651858.CD012884] ; (b)Martínez G, Vernooij RWM, Fuentes Padilla P, Zamora J, Flicker L, Bonfill Cosp X. 18F PET with florbetaben for the early diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2017; (11): CD012883
[http://dx.doi.org/10.1002/14651858.CD012883] ; (c)Martínez G, Vernooij RWM, Fuentes Padilla P, Zamora J, Bonfill Cosp X, Flicker L. 18F PET with florbetapir for the early diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2017; (11): CD012216
[http://dx.doi.org/10.1002/14651858.CD012216.pub2] ; (d)Zhang S, Smailagic N, Hyde C, et al. (11)C-PIB-PET for the early diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2014; (7): CD010386
[http://dx.doi.org/10.1002/14651858.CD010386.pub2] [PMID: 25052054]
[17]
Colective Proceso Asistencial Integrado. Demencia (PAI). Sevilla: Conserjería de Salud 2002.
[18]
Lendínez A, Zunzunegui MV, Iribar C, Carnero-Pardo C, González-Maldonado R. Validación de constructo de la batería abreviada Granada de evaluación neuropsicológica. Rev Mult Gerontol 2000; 10(3): 152-7.
[19]
Carnero Pardo C, Sáez-Zea C, Montiel Navarro L, et al. Diagnostic accuracy of the Phototest for cognitive impairment and dementia. Neurologia 2007; 22(10): 860-9.
[PMID: 18040903]
[20]
Herukka SK, Simonsen AH, Andreasen N, et al. Recommendations for cerebrospinal fluid Alzheimer’s disease biomarkers in the diagnostic evaluation of mild cognitive impairment. Alzheimers Dement 2017; 13(3): 285-95.
[http://dx.doi.org/10.1016/j.jalz.2016.09.009] [PMID: 28341066]
[21]
Minoshima S, Drzezga AE, Barthel H, et al. SNMMI procedure standard/EANM practice guideline for amyloid PET imaging of the brain 1.0. J Nucl Med 2016; 57(8): 1316-22.
[http://dx.doi.org/10.2967/jnumed.116.174615] [PMID: 27481605]
[22]
Sabri O, Seibyl J, Rowe C, Barthel H. Beta-amyloid imaging with florbetaben.Clin Transl Imaging 3 (1):13-26 (2015)J Alzheimers Dis 2020; 73(2): 559-69.
[PMID: 31796674]
[23]
Reimand J, Groot C, Teunissen CE, et al. Why is amyloid-β PET requested after performing CSF biomarkers? J Alzheimers Dis 2020; 73(2): 559-69.
[http://dx.doi.org/10.3233/JAD-190836] [PMID: 31796674]
[24]
Vos SJ, Visser PJ, Verhey F, et al. Variability of CSF Alzheimer’s disease biomarkers: Implications for clinical practice. PLoS One 2014; 9(6)e100784
[http://dx.doi.org/10.1371/journal.pone.0100784] [PMID: 24959687]
[25]
Müller EG, Edwin TH, Stokke C, et al. Amyloid-β PET-Correlation with cerebrospinal fluid biomarkers and prediction of Alzheimer’s disease diagnosis in a memory clinic. PLoS One 2019; 14(8)e0221365
[http://dx.doi.org/10.1371/journal.pone.0221365] [PMID: 31430334]
[26]
Morbelli S, Bauckneht M, Scheltens P. Imaging biomarkers in Alzheimer’s disease: Added value in the clinical setting. Q J Nucl Med Mol Imaging 2017; 61(4): 360-71.
[PMID: 28750495]
[27]
de Wilde A, Reimand J, Teunissen CE, et al. Discordant amyloid-β PET and CSF biomarkers and its clinical consequences. Alzheimers Res Ther 2019; 11(1): 78.
[http://dx.doi.org/10.1186/s13195-019-0532-x] [PMID: 31511058]
[28]
Lehmann S, Teunissen CE. Editorial: Biomarkers of Alzheimer’s dis-ease: The present and the future. Front Neurol 2016; 7: 158.
[http://dx.doi.org/10.3389/fneur.2016.00158] [PMID: 27729897]
[29]
Mattsson N, Andreasson U, Persson S, et al. The Alzheimer’s association external quality control program for cerebrospinal fluid biomarkers. Alzheimers Dement 2011; 7(4): 386-95.
[http://dx.doi.org/10.1016/j.jalz.2011.05.2243]
[30]
Carrillo MC, Blennow K, Soares H, et al. Global standardization measurement of cerebral spinal fluid for Alzheimer’s disease: an update from the Alzheimer’s Association Global Biomarkers Consortium. Alzheimers Dement 2013; 9(2): 137-40.
[http://dx.doi.org/10.1016/j.jalz.2012.11.003] [PMID: 23274154]
[31]
Reimand J, de Wilde A, Teunissen CE, et al. PET and CSF amyloid-β status are differently predicted by patient features: Information from discordant cases. Alzheimers Res Ther 2019; 11(1): 100.
[http://dx.doi.org/10.1186/s13195-019-0561-5] [PMID: 31810489]
[32]
Sauveé M. DidierLaurent G, Latarchec C, Escanyé M, Olivier J, Malaplate-Armand C. Additional use of A42/A40 ratio with cerebrospinal fluid biomarkers P-Tau and A42 increases the level of evidence of Alzheimer’s disease pathophysiological process in routine practice. J Alzheimers Dis 2014; 41(2): 377-86.
[http://dx.doi.org/10.3233/JAD-131838] [PMID: 24614902]
[33]
Lewczuk P, Matzen A, Blennow K, et al. Cerebrospinal fluid Abeta 42/40 corresponds better than Abeta42 to amiloide PET in Alzheimer Disease. J Alzheimers Dis 2017; 55(2): 813-22.
[http://dx.doi.org/10.3233/JAD-160722] [PMID: 27792012]
[34]
Dorey A, Perret-Liaudet A, Tholance Y, Fourier A, Quadrio I. Cerebrospinal fluid Aβ40 improves the interpretation of Aβ42 concentration for diagnosing Alzheimer’s disease. Front Neurol 2015; 6(247): 247.
[http://dx.doi.org/10.3389/fneur.2015.00247] [PMID: 26640457]
[35]
Janelidze S, Zetterberg H, Mattsson N, et al. Swedish BioFINDER study group. CSF Aβ42/Aβ40 and Aβ42/Aβ38 ratios: Better diagnostic markers of Alzheimer disease. Ann Clin Transl Neurol 2016; 3(3): 154-65.
[http://dx.doi.org/10.1002/acn3.274] [PMID: 27042676]
[36]
Palmqvist S, Zetterberg H, Blennow K, et al. Accuracy of brain amyloid detection in clinical practice using cerebrospinal fluid β-amyloid 42: A cross-validation study against amyloid positron emission tomography. JAMA Neurol 2014; 71(10): 1282-9.
[http://dx.doi.org/10.1001/jamaneurol.2014.1358] [PMID: 25155658]
[37]
Hansson O, Seibyl J, Stomrud E, et al. Swedish BioFINDER study group; Alzheimer’s Disease Neuroimaging Initiative. CSF biomarkers of Alzheimer’s disease concord with amyloid-β PET and predict clinical progression: A study of fully automated immunoassays in BioFINDER and ADNI cohorts. Alzheimers Dement 2018; 14(11): 1470-81.
[http://dx.doi.org/10.1016/j.jalz.2018.01.010] [PMID: 29499171]
[38]
Kaplow J, Vandijck M, Gray J, et al. Concordance of Lumipulse cerebrospinal fluid t-tau/Aβ42 ratio with amyloid PET status. Alzheimers Dement 2020; 16(1): 144-52.
[http://dx.doi.org/10.1002/alz.12000] [PMID: 31914216]
[39]
Zwan MD, Rinne JO, Hasselbalch SG, et al. Use of amyloid-PET to determine cutpoints for CSF markers: A multicenter study. Neurology 2016; 86(1): 50-8.
[http://dx.doi.org/10.1212/WNL.0000000000002081] [PMID: 26468410]
[40]
Pontecorvo MJ, Siderowf A, Dubois B, et al. Effectiveness of florbetapir PET imaging in changing patient management. Dement Geriatr Cogn Disord 2017; 44(3-4): 129-43.
[http://dx.doi.org/10.1159/000478007] [PMID: 28787712]
[41]
Weidman DA, Zamrini E, Sabbagh MN, et al. Added value and limitations of amyloid-PET imaging: Review and analysis of selected cases of mild cognitive impairment and dementia. Neurocase 2017; 23(1): 41-51.
[http://dx.doi.org/10.1080/13554794.2017.1290806] [PMID: 28376695]
[42]
Apostolova LG, Haider JM, Goukasian N, et al. Critical review of the appropriate use criteria for amyloid imaging: Effect on diagnosis and patient care. Alzheimers Dement (Amst) 2016; 5: 15-22.
[http://dx.doi.org/10.1016/j.dadm.2016.12.001] [PMID: 28054024]
[43]
Paterson RW, Toombs J, Slattery CF, et al. Dissecting IWG-2 typical and atypical Alzheimer’s disease: Insights from cerebrospinal fluid analysis. J Neurol 2015; 262(12): 2722-30.
[http://dx.doi.org/10.1007/s00415-015-7904-3] [PMID: 26410752]
[44]
Winblad B, Amouyel P, Andrieu S, et al. Defeating Alzheimer’s disease and other dementias: A priority for European science and society. Lancet Neurol 2016; 15(5): 455-532.
[http://dx.doi.org/10.1016/S1474-4422(16)00062-4] [PMID: 26987701]

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