Abstract
| Original language | English |
|---|---|
| Journal | Eur. J. Neurol. |
| DOIs | |
| Publication status | E-pub ahead of print - Nov 6 2019 |
Keywords
- Alzheimer’s disease
- biomarker
- biomarker-based diagnosis
- consensus recommendations
- diagnosis
- diagnostic algorithm
- implementation
- MCI
- multiple biomarkers
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Italian consensus recommendations for a biomarker-based aetiological diagnosis in mild cognitive impairment patients : European Journal of Neurology. / Boccardi, M.; Nicolosi, V.; Festari, C. et al.
In: Eur. J. Neurol., 06.11.2019.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Italian consensus recommendations for a biomarker-based aetiological diagnosis in mild cognitive impairment patients
T2 - European Journal of Neurology
AU - Boccardi, M.
AU - Nicolosi, V.
AU - Festari, C.
AU - Bianchetti, A.
AU - Cappa, S.
AU - Chiasserini, D.
AU - Falini, A.
AU - Guerra, U.P.
AU - Nobili, F.
AU - Padovani, A.
AU - Sancesario, G.
AU - Morbelli, S.
AU - Parnetti, L.
AU - Tiraboschi, P.
AU - Muscio, C.
AU - Perani, D.
AU - Pizzini, F.B.
AU - Beltramello, A.
AU - Salvini Porro, G.
AU - Ciaccio, M.
AU - Schillaci, O.
AU - Trabucchi, M.
AU - Tagliavini, F.
AU - Frisoni, G.B.
N1 - Export Date: 10 February 2020 CODEN: EJNEF Correspondence Address: Frisoni, G.B.; IRCCS Istituto Centro S.Giovanni di Dio-FatebenefratelliItaly; email: giovanni.frisoni@unige.ch Funding details: 115952 Funding details: NET‐2011‐02346784 Funding details: Novartis Funding details: AbbVie Funding details: General Electric, GE Funding details: ACADIA Pharmaceuticals, ACADIA Funding text 1: These recommendations represent the opinion of the scientific societies officially represented by: Flavio Nobili and Ugo Paolo Guerra for AIMN (final formal societal approval February 2019); Andrea Falini for AINR (February 2019); Marco Trabucchi for AIP (January 2019); Giulia Sancesario for SIBioC ( a priori societal approval); Stefano Cappa for SINdem (March 2019); and Gabriella Salvini Porro for Federazione Alzheimer Italia (February 2019). The work was funded by the Italian Health Ministry grant NET‐2011‐02346784 and by the EU‐EFPIA Innovative Medicines Initiative 2 Joint Undertaking grant 115952 (AMYPAD). Funding text 2: Personal fees were received by Drs/Profs Boccardi (Eli‐Lilly; Piramal), Cappa (Nutricia, Roche, Biogen), Frisoni (imaging and pharma companies), Morbelli (Eli‐Lilly, General Electric), Schillaci (Alliance Medical). Professor Frisoni is the principal investigator of industry‐sponsored trials funded by AbbVie, Acadia, Altoida, Amoneta, Araclon, Biogen, Janssen, Novartis, Piramal; has received funding for investigator‐initiated trials from GE, Piramal and Avid‐Lilly. The other authors declare no conflicts of interest. 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PY - 2019/11/6
Y1 - 2019/11/6
N2 - Background and purpose: Biomarkers support the aetiological diagnosis of neurocognitive disorders in vivo. Incomplete evidence is available to drive clinical decisions; available diagnostic algorithms are generic and not very helpful in clinical practice. The aim was to develop a biomarker-based diagnostic algorithm for mild cognitive impairment patients, leveraging on knowledge from recognized national experts. Methods: With a Delphi procedure, experienced clinicians making variable use of biomarkers in clinical practice and representing five Italian scientific societies (neurology – Società Italiana di Neurologia per le Demenze; neuroradiology – Associazione Italiana di Neuroradiologia; biochemistry – Società Italiana di Biochimica Clinica; psychogeriatrics – Associazione Italiana di Psicogeriatria; nuclear medicine – Associazione Italiana di Medicina Nucleare) defined the theoretical framework, relevant literature, the diagnostic issues to be addressed and the diagnostic algorithm. An N–1 majority defined consensus achievement. Results: The panellists chose the 2011 National Institute on Aging and Alzheimer's Association diagnostic criteria as the reference theoretical framework and defined the algorithm in seven Delphi rounds. The algorithm includes baseline clinical and cognitive assessment, blood examination, and magnetic resonance imaging with exclusionary and inclusionary roles; dopamine transporter single-photon emission computed tomography (if no/unclear parkinsonism) or metaiodobenzylguanidine cardiac scintigraphy for suspected dementia with Lewy bodies with clear parkinsonism (round VII, votes (yes-no-abstained): 3-1-1); 18F-fluorodeoxyglucose positron emission tomography for suspected frontotemporal lobar degeneration and low diagnostic confidence of Alzheimer’s disease (round VII, 4-0-1); cerebrospinal fluid for suspected Alzheimer’s disease (round IV, 4-1-0); and amyloid positron emission tomography if cerebrospinal fluid was not possible/accepted (round V, 4-1-0) or inconclusive (round VI, 5-0-0). Conclusions: These consensus recommendations can guide clinicians in the biomarker-based aetiological diagnosis of mild cognitive impairment, whilst guidelines cannot be defined with evidence-to-decision procedures due to incomplete evidence. © 2019 European Academy of Neurology
AB - Background and purpose: Biomarkers support the aetiological diagnosis of neurocognitive disorders in vivo. Incomplete evidence is available to drive clinical decisions; available diagnostic algorithms are generic and not very helpful in clinical practice. The aim was to develop a biomarker-based diagnostic algorithm for mild cognitive impairment patients, leveraging on knowledge from recognized national experts. Methods: With a Delphi procedure, experienced clinicians making variable use of biomarkers in clinical practice and representing five Italian scientific societies (neurology – Società Italiana di Neurologia per le Demenze; neuroradiology – Associazione Italiana di Neuroradiologia; biochemistry – Società Italiana di Biochimica Clinica; psychogeriatrics – Associazione Italiana di Psicogeriatria; nuclear medicine – Associazione Italiana di Medicina Nucleare) defined the theoretical framework, relevant literature, the diagnostic issues to be addressed and the diagnostic algorithm. An N–1 majority defined consensus achievement. Results: The panellists chose the 2011 National Institute on Aging and Alzheimer's Association diagnostic criteria as the reference theoretical framework and defined the algorithm in seven Delphi rounds. The algorithm includes baseline clinical and cognitive assessment, blood examination, and magnetic resonance imaging with exclusionary and inclusionary roles; dopamine transporter single-photon emission computed tomography (if no/unclear parkinsonism) or metaiodobenzylguanidine cardiac scintigraphy for suspected dementia with Lewy bodies with clear parkinsonism (round VII, votes (yes-no-abstained): 3-1-1); 18F-fluorodeoxyglucose positron emission tomography for suspected frontotemporal lobar degeneration and low diagnostic confidence of Alzheimer’s disease (round VII, 4-0-1); cerebrospinal fluid for suspected Alzheimer’s disease (round IV, 4-1-0); and amyloid positron emission tomography if cerebrospinal fluid was not possible/accepted (round V, 4-1-0) or inconclusive (round VI, 5-0-0). Conclusions: These consensus recommendations can guide clinicians in the biomarker-based aetiological diagnosis of mild cognitive impairment, whilst guidelines cannot be defined with evidence-to-decision procedures due to incomplete evidence. © 2019 European Academy of Neurology
KW - Alzheimer’s disease
KW - biomarker
KW - biomarker-based diagnosis
KW - consensus recommendations
KW - diagnosis
KW - diagnostic algorithm
KW - implementation
KW - MCI
KW - multiple biomarkers
U2 - 10.1111/ene.14117
DO - 10.1111/ene.14117
M3 - Article
JO - Eur. J. Neurol.
JF - Eur. J. Neurol.
SN - 1351-5101
ER -