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[阿尔茨海默病的新定义]

[A new definition for Alzheimer's disease].

作者信息

Dubois Bruno

出版信息

Bull Acad Natl Med. 2013 Jan;197(1):143-53; discussion 153-6.

Abstract

In 2007 and 2010, the International Working Group on Research Criteria for Alzheimer's Disease introduced a new conceptual framework that included a diagnostic algorithm covering early prodromal stages. There is a growing consensus that Alzheimer's disease (AD) should be considered as a clinical-biological entity characterized by: i) a well-defined clinical phenotype (an amnestic syndrome of the hippocampal type in typical AD), and ii) biomarkers, especially pathophysiological biomarkers, of the underlying disease process. The IWG criteria created the possibility for AD to be diagnosed prior to the onset of dementia, and also integrated biomarkers into the diagnostic framework. Although these criteria were intended for research purposes, they are increasingly used in expert centers for early diagnosis, for example of young-onset AD and complex cases (posterior cortical atrophy, primary progressive aphasia, etc.), where biomarkers can improve the diagnostic accuracy. In this article we present this new approach, together with the results of ongoing validation studies and data obtained by a French research team.

摘要

2007年和2010年,国际阿尔茨海默病研究标准工作组引入了一个新的概念框架,其中包括一个涵盖早期前驱阶段的诊断算法。越来越多的人达成共识,即阿尔茨海默病(AD)应被视为一种临床生物学实体,其特征为:i)明确的临床表型(典型AD中的海马型遗忘综合征),以及ii)潜在疾病过程的生物标志物,尤其是病理生理学生物标志物。国际工作组的标准使得在痴呆症发作之前诊断AD成为可能,并且还将生物标志物纳入了诊断框架。尽管这些标准旨在用于研究目的,但它们在专家中心越来越多地用于早期诊断,例如早发型AD和复杂病例(后部皮质萎缩、原发性进行性失语等),在这些病例中生物标志物可以提高诊断准确性。在本文中,我们介绍这种新方法,以及正在进行的验证研究结果和一个法国研究团队获得的数据。

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