Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting

Daniela Perani, Chiara Cerami, Silvia Paola Caminiti, Roberto Santangelo, Elisabetta Coppi, Laura Ferrari, Patrizia Pinto, Gabriella Passerini, Andrea Falini, Sandro Iannaccone, Stefano Francesco Cappa, Giancarlo Comi, Luigi Gianolli, Giuseppe Magnani

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)499-508
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume43
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

Keywords

  • Alzheimer’s Disease
  • Biomarkers
  • Clinical setting
  • Dementia diagnosis
  • Mild Cognitive Impairment

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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