Relevance of Follow-Up in Patients with Core Clinical Criteria for Alzheimer Disease and Normal CSF Biomarkers.

Autor: Vercruysse O; University Lille, Inserm U1171, Centre Memoire de Ressources et de Recherche & CNR-MAJ, CHU Lille, F-59000 Lille, France., Paquet C; Centre Memoire de Ressources et de Recherche Paris Nord, Unite d`Histologie et de Biologie du Vieillissement, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Universite Paris Diderot, et INSERM U942, Paris, France., Gabelle A; Centre Memoire de Ressources et de Recherche, Departement de Neurologie, Hopital Universitaire Gui de Chauliac, Universite de Montpellier, INSERM U1183, Hopital Saint Eloi, Montpellier, France., Delbeuck X; University Lille, Inserm U1171, Centre Memoire de Ressources et de Recherche & CNR-MAJ, CHU Lille, F-59000 Lille, France., Blanc F; Unite de Neuropsychologie et Centre Memoire Ressources Recherche, service de Neurologie, Hopitaux Universitaires de Strasbourg, et Laboratoire ICube, Universite de Strasbourg et CNRS, Strasbourg, France., Wallon D; Centre Memoire de Ressources et de Recherche & CNR-MAJ, INSERM U1079, 76000, Rouen University Hospital, France., Dumurgier J; Centre Memoire de Ressources et de Recherche Paris Nord, Unite d`Histologie et de Biologie du Vieillissement, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Universite Paris Diderot, et INSERM U942, Paris, France., Magnin E; Centre Memoire de Ressources et de Recherche, service de Neurologie, CHU de Besancon, France., Martinaud O; Centre Memoire de Ressources et de Recherche & CNR-MAJ, INSERM U1079, 76000, Rouen University Hospital, France., Jung B; Unite de Neuropsychologie et Centre Memoire Ressources Recherche, service de Neurologie, Hopitaux Universitaires de Strasbourg, et Laboratoire ICube, Universite de Strasbourg et CNRS, Strasbourg, France., Bousiges O; Laboratoire de Biochimie et de Biologie Moleculaire, Hopitaux Universitaires de Strasbourg, et Laboratoire de Neurosciences Cognitives et Adaptatives, Universite de Strasbourg et CNRS, Strasbourg, France., Lehmann S; CHU de Montpellier, Hopital St Eloi Universite de Montpellier and INSERM U1183, IRMB, CRB, Laboratoire de Biochimie Proteomique Clinique, Montpellier, France., Delaby C; CHU de Montpellier, Hopital St Eloi Universite de Montpellier and INSERM U1183, IRMB, CRB, Laboratoire de Biochimie Proteomique Clinique, Montpellier, France., Quillard-Murain M; Laboratoire de Biochimie & Centre de Recherche Biologique, Hopital Universitaire, Rouen, France., Peoc H K; Service de Biochimie et Biologie moleculaire, Hopital Lariboisiere-Fernand Widal, APHP, Universite Paris Diderot, Universite Paris Descartes, Paris, France., Laplanche JL; Service de Biochimie et Biologie moleculaire, Hopital Lariboisiere-Fernand Widal, APHP, Universite Paris Diderot, Universite Paris Descartes, Paris, France., Bouaziz-Amar E; Service de Biochimie et Biologie moleculaire, Hopital Lariboisiere-Fernand Widal, APHP, Universite Paris Diderot, Universite Paris Descartes, Paris, France., Hannequin D; Centre Memoire de Ressources et de Recherche & CNR-MAJ, INSERM U1079, 76000, Rouen University Hospital, France., Sablonniere B; University Lille, INSERM, CHU-Lille, Alzheimer & Tauopathies, F-59000 Lille, France.; University Lille, CHU-Lille, Centre de Biologie Pathologie UF de Neurobiologie, F-59000 Lille, France., Buee L; University Lille, INSERM, CHU-Lille, Alzheimer & Tauopathies, F-59000 Lille, France., Hugon J; Centre Memoire de Ressources et de Recherche Paris Nord, Unite d`Histologie et de Biologie du Vieillissement, Groupe Hospitalier Lariboisiere FW Saint-Louis, APHP, Universite Paris Diderot, et INSERM U942, Paris, France., Schraen S; University Lille, INSERM, CHU-Lille, Alzheimer & Tauopathies, F-59000 Lille, France.; University Lille, CHU-Lille, Centre de Biologie Pathologie UF de Neurobiologie, F-59000 Lille, France., Pasquier F; University Lille, Inserm U1171, Centre Memoire de Ressources et de Recherche & CNR-MAJ, CHU Lille, F-59000 Lille, France., Bombois S; University Lille, Inserm U1171, Centre Memoire de Ressources et de Recherche & CNR-MAJ, CHU Lille, F-59000 Lille, France., For The E-Plm Group
Jazyk: angličtina
Zdroj: Current Alzheimer research [Curr Alzheimer Res] 2018; Vol. 15 (7), pp. 691-700.
DOI: 10.2174/1567205015666180110113238
Abstrakt: Background: Few patients with a normal cerebrospinal fluid (CSF) biomarker profile fulfill the clinical criteria for Alzheimer disease (AD).
Objective: The aim of this study was to test the hypothesis of misdiagnoses for these patients.
Method: Patients from the e-PLM centers fulfilling the core clinical criteria for probable AD dementia or mild cognitive impairment due to AD (AD-MCI), with normal CSF Aβ1-42, T-tau and P-tau biomarkers and clinical follow-up, were included. Clinical and imaging data were reviewed by an independent board, from baseline (visit with clinical evaluation and CSF analysis) to the end of the follow-up, for a final diagnosis.
Results: In the e-PLM cohort of 1098 AD patients with CSF analysis, 37 (3.3%) patients (20 with AD dementia core clinical criteria and 17 with AD-MCI core clinical criteria) had normal CSF biomarker profile and a clinical follow-up. All patients presented with episodic memory impairment and 27 (73%) had medial temporal lobe atrophy on MRI-scan. After a median follow-up of 36 months (range 7-74), the final diagnosis was AD MCI or dementia for 9 (24%) patients, and unlikely due to AD for 28 (76%) patients. A misdiagnosis was corrected in 18 (49%) patients (mood disorders, non-AD degenerative dementia, vascular cognitive impairment, alcohol cognitive disorders, temporal epilepsy and hippocampal sclerosis), and 10 (27%) patients had cognitive disorders of undetermined etiology.
Conclusion: AD diagnosis (MCI or dementia) with normal CSF biomarkers is a rare condition. A clinical follow- up is particularly recommended to consider an alternative diagnosis.
(Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)
Databáze: MEDLINE