摘要
背景:在研究背景和专门护理中广泛探索使用成像标志物来诊断阿尔茨海默氏病(AD)痴呆前期和早期痴呆阶段。这些标记在初级保健中的使用尚未建立。 目的:总结现有的证据显示,与专门的护理机构相比,AD的成像标记物在初级治疗中的有用性。 方法:文献的选择性综述以及使用基于MRI的海马和基底前脑容积的方法对来自健康对照的AD痴呆和轻度认知障碍(MCI)病例的58例初级保健队列和58例来自记忆门诊样本的匹配病例。 结果:淀粉样蛋白病理学的分子成像标志物和区域性和全脑萎缩的体积标志物支持AD对AD痴呆和MCI的诊断,并有助于在专门护理中鉴别AD和非AD相关痴呆的信心。来自文献和我们的初级保健队列的有限证据表明,体积成像标志物的诊断准确性在AD的痴呆阶段可能相似,但与专门护理相比,MCI初级的病例可能较差。 结论:AD患者早期和鉴别诊断中使用影像学标记物以及初级保健中前驱AD的检测依然缺乏证据。填补这一空白的进一步进展将取决于明确定义的初级保健人群的国际多模式数据的可用性。
关键词: 初级保健,海马体积测定,淀粉样蛋白PET,早期诊断,MCI,临床前阿尔茨海默病。
Current Alzheimer Research
Title:Potential Role of Neuroimaging Markers for Early Diagnosis of Dementia in Primary Care
Volume: 15 Issue: 1
关键词: 初级保健,海马体积测定,淀粉样蛋白PET,早期诊断,MCI,临床前阿尔茨海默病。
摘要: Background: The use of imaging markers for the diagnosis of predementia and early dementia stages of Alzheimer's disease (AD) has widely been explored in research settings and specialized care. The use of these markers in primary care has yet to be established.
Objective: Summarize current evidence for the usefulness of imaging markers for AD in primary compared to specialized care settings.
Method: Selective overview of the literature, and pilot data on the use of MRI-based hippocampus and basal forebrain volumetry for the discrimination of AD dementia and mild cognitive impairment (MCI) cases from healthy controls in 58 cases from a primary care cohort and 58 matched cases from a memory clinic's sample.
Results: Molecular imaging marker of amyloid pathology, and volumetric markers of regional and whole brain atrophy support the diagnosis of AD dementia and MCI due to AD, and contribute to confidence in the differential diagnosis of AD and non-AD related dementias in specialized care. Limited evidence from the literature and our primary care cohort suggests that the diagnostic accuracy of volumetric imaging markers may be similar in the dementia stage of AD, but may be inferior for cases with MCI in primary compared with specialized care.
Conclusion: Evidence is still widely lacking on the use of imaging markers for early and differential diagnosis of AD dementia, and detection of prodromal AD in primary care. Further progress to fill this gap will depend on the availability of international multimodal data from well-defined primary care cohorts.
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Cite this article as:
Potential Role of Neuroimaging Markers for Early Diagnosis of Dementia in Primary Care, Current Alzheimer Research 2018; 15 (1) . https://dx.doi.org/10.2174/1567205014666170908093846
DOI https://dx.doi.org/10.2174/1567205014666170908093846 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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