Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
Alzheimers Dement. 2017 Mar;13(3):274-284. doi: 10.1016/j.jalz.2016.09.008. Epub 2016 Oct 27.
This article presents recommendations, based on the Grading of Recommendations, Assessment, Development, and Evaluation method, for the clinical application of cerebrospinal fluid (CSF) amyloid-β, tau, and phosphorylated tau in the diagnostic evaluation of patients with dementia. The recommendations were developed by a multidisciplinary working group based on the available evidence and consensus from focused discussions for (i) identification of Alzheimer's disease (AD) as the cause of dementia, (ii) prediction of rate of decline, (iii) cost-effectiveness, and (iv) interpretation of results. The working group found sufficient evidence to support a recommendation to use CSF AD biomarkers as a supplement to clinical evaluation, particularly in uncertain and atypical cases, to identify or exclude AD as the cause of dementia. Because of insufficient evidence, it was uncertain whether CSF AD biomarkers outperform imaging biomarkers. Operational recommendations for the interpretation of ambiguous CSF biomarker results were also provided.
本文根据推荐意见的分级、评估、制定与评价方法，就脑脊液（CSF）淀粉样蛋白-β、tau 蛋白和磷酸化 tau 蛋白在痴呆患者的诊断评估中的临床应用提出了相关建议。这些建议是由一个多学科工作组根据现有证据以及通过集中讨论达成的共识制定的，涉及以下四个方面：（i）确定痴呆的病因是否为阿尔茨海默病（AD）；（ii）预测衰退速度；（iii）成本效益；（iv）解读结果。工作组发现，有充分的证据支持使用 CSF AD 生物标志物作为临床评估的补充，尤其是在不确定和非典型病例中，以确定或排除 AD 作为痴呆的病因。由于证据不足，尚不确定 CSF AD 生物标志物是否优于影像学生物标志物。此外，还提供了用于解读 CSF 生物标志物结果不明确的操作性建议。
