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Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting.
Eur J Nucl Med Mol Imaging. 2016 Mar; 43(3):499-508.EJ

Abstract

PURPOSE

The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI).

METHODS

We evaluated the supportive role of CSF Aβ42, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression.

RESULTS

Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ42 ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease.

CONCLUSION

In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ42 ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role.

Authors+Show Affiliations

Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy. perani.daniela@hsr.it. Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy. perani.daniela@hsr.it. Nuclear Medicine Unit, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy. perani.daniela@hsr.it.Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy. Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy. Clinical Neuroscience Department, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy.Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy. Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy.Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy.Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy.Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy.Department of Neurology, Papa Giovanni XXIII Hospital, Piazza OMS, 1, 24127, Bergamo, Italy.Servizio di Medicina di Laboratorio OSR, Via Olgettina, 60, 20132, Milan, Italy.Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy. Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy. CERMAC - Department of Neuroradiology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy.Clinical Neuroscience Department, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy.Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina, 58, 20132, Milan, Italy. IUSS Pavia, Piazza della Vittoria, 15, 27100, Pavia, Italy.Vita-Salute San Raffaele University, Via Olgettina, 58, 20132, Milan, Italy. Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy.Nuclear Medicine Unit, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy.Department of Neurology, San Raffaele Hospital, Via Olgettina, 60, 20132, Milan, Italy. magnani.giuseppe@hsr.it.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26341365

Citation

Perani, Daniela, et al. "Cross-validation of Biomarkers for the Early Differential Diagnosis and Prognosis of Dementia in a Clinical Setting." European Journal of Nuclear Medicine and Molecular Imaging, vol. 43, no. 3, 2016, pp. 499-508.
Perani D, Cerami C, Caminiti SP, et al. Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting. Eur J Nucl Med Mol Imaging. 2016;43(3):499-508.
Perani, D., Cerami, C., Caminiti, S. P., Santangelo, R., Coppi, E., Ferrari, L., Pinto, P., Passerini, G., Falini, A., Iannaccone, S., Cappa, S. F., Comi, G., Gianolli, L., & Magnani, G. (2016). Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting. European Journal of Nuclear Medicine and Molecular Imaging, 43(3), 499-508. https://doi.org/10.1007/s00259-015-3170-y
Perani D, et al. Cross-validation of Biomarkers for the Early Differential Diagnosis and Prognosis of Dementia in a Clinical Setting. Eur J Nucl Med Mol Imaging. 2016;43(3):499-508. PubMed PMID: 26341365.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting. AU - Perani,Daniela, AU - Cerami,Chiara, AU - Caminiti,Silvia Paola, AU - Santangelo,Roberto, AU - Coppi,Elisabetta, AU - Ferrari,Laura, AU - Pinto,Patrizia, AU - Passerini,Gabriella, AU - Falini,Andrea, AU - Iannaccone,Sandro, AU - Cappa,Stefano Francesco, AU - Comi,Giancarlo, AU - Gianolli,Luigi, AU - Magnani,Giuseppe, Y1 - 2015/09/04/ PY - 2015/04/06/received PY - 2015/08/10/accepted PY - 2015/9/6/entrez PY - 2015/9/6/pubmed PY - 2016/11/2/medline KW - Alzheimer’s Disease KW - Biomarkers KW - Clinical setting KW - Dementia diagnosis KW - Mild Cognitive Impairment SP - 499 EP - 508 JF - European journal of nuclear medicine and molecular imaging JO - Eur J Nucl Med Mol Imaging VL - 43 IS - 3 N2 - PURPOSE: The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). METHODS: We evaluated the supportive role of CSF Aβ42, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. RESULTS: Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ42 ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. CONCLUSION: In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ42 ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role. SN - 1619-7089 UR - https://www.unboundmedicine.com/medline/citation/26341365/Cross_validation_of_biomarkers_for_the_early_differential_diagnosis_and_prognosis_of_dementia_in_a_clinical_setting_ L2 - https://dx.doi.org/10.1007/s00259-015-3170-y DB - PRIME DP - Unbound Medicine ER -