التفاصيل البيبلوغرافية
| العنوان: |
Alzheimer's Disease Diagnosis Based on the Amyloid, Tau, and Neurodegeneration Scheme (ATN) in a Real-Life Multicenter Cohort of General Neurological Centers. |
| المؤلفون: |
Baldeiras, Inês, Silva-Spínola, Anuschka, Lima, Marisa, Leitão, Maria João, Durães, João, Vieira, Daniela, Tábuas-Pereira, Miguel, Cruz, Vitor Tedim, Rocha, Raquel, Alves, Luisa, Machado, Álvaro, Milheiro, Miguel, Santiago, Beatriz, Santana, Isabel, Tbuas-Pereira, Miguel |
| المصدر: |
Journal of Alzheimer's Disease; 2022, Vol. 90 Issue 1, p419-432, 14p |
| مصطلحات موضوعية: |
ALZHEIMER'S disease diagnosis, PROTEINS, EVALUATION research, QUESTIONNAIRES, AMYLOIDOSIS, PEPTIDES, NERVE tissue proteins, RESEARCH, RESEARCH methodology, COMPARATIVE studies |
| مستخلص: |
Background: The ATN scheme was proposed as an unbiased biological characterization of the Alzheimer's disease (AD) spectrum, grouping biomarkers into three categories: brain Amyloidosis-A, Tauopathy-T, Neurodegeneration-N. Although this scheme was mainly recommended for research, it is relevant for diagnosis.Objective: To evaluate the ATN scheme performance in real-life cohorts reflecting the inflow of patients with cognitive complaints and different underlying disorders in general neurological centers.Methods: We included patients (n = 1,128) from six centers with their core cerebrospinal fluid-AD biomarkers analyzed centrally. A was assessed through Aβ42/Aβ40, T through pTau-181, and N through tTau. Association between demographic features, clinical diagnosis at baseline/follow-up and ATN profiles was assessed.Results: The prevalence of ATN categories was: A-T-N-: 28.3%; AD continuum (A + T-/+N-/+): 47.8%; non-AD (A- plus T or/and N+): 23.9%. ATN profiles prevalence was strongly influenced by age, showing differences according to gender, APOE genotype, and cognitive status. At baseline, 74.6% of patients classified as AD fell in the AD continuum, decreasing to 47.4% in mild cognitive impairment and 42.3% in other neurodegenerative conditions. At follow-up, 41% of patients changed diagnosis, and 92% of patients that changed to AD were classified within the AD continuum. A + was the best individual marker for predicting a final AD diagnosis, and the combinations A + T+ (irrespective of N) and A + T+N+ had the highest overall accuracy (83%).Conclusion: The ATN scheme is useful to guide AD diagnosis in real-life neurological centers settings. However, it shows a lack of accuracy for patients with other types of dementia. In such cases, the inclusion of other markers specific for non-AD proteinopathies could be an important aid to the differential diagnosis. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
