Bruun Marie, Rhodius-Meester Hanneke F M, Koikkalainen Juha, Baroni Marta, Gjerum Le, Lemstra Afina W, Barkhof Frederik, Remes Anne M, Urhemaa Timo, Tolonen Antti, Rueckert Daniel, van Gils Mark, Frederiksen Kristian S, Waldemar Gunhild, Scheltens Philip, Mecocci Patrizia, Soininen Hilkka, Lötjönen Jyrki, Hasselbalch Steen G, van der Flier Wiesje M
Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, the Netherlands.
Alzheimers Dement (Amst). 2018 Aug 17;10:509-518. doi: 10.1016/j.dadm.2018.07.003. eCollection 2018.
We studied, using a data-driven approach, how different combinations of diagnostic tests contribute to the differential diagnosis of dementia.
In this multicenter study, we included 356 patients with Alzheimer's disease, 87 frontotemporal dementia, 61 dementia with Lewy bodies, 38 vascular dementia, and 302 controls. We used a classifier to assess accuracy for individual performance and combinations of cognitive tests, cerebrospinal fluid biomarkers, and automated magnetic resonance imaging features for pairwise differentiation between dementia types.
Cognitive tests had good performance in separating any type of dementia from controls. Cerebrospinal fluid optimally contributed to identifying Alzheimer's disease, whereas magnetic resonance imaging features aided in separating vascular dementia, dementia with Lewy bodies, and frontotemporal dementia. Combining diagnostic tests increased the accuracy, with balanced accuracies ranging from 78% to 97%.
Different diagnostic tests have their distinct roles in differential diagnostics of dementias. Our results indicate that combining different diagnostic tests may increase the accuracy further.
我们采用数据驱动的方法，研究了不同组合的诊断测试如何有助于痴呆症的鉴别诊断。
在这项多中心研究中，我们纳入了356例阿尔茨海默病患者、87例额颞叶痴呆患者、61例路易体痴呆患者、38例血管性痴呆患者以及302例对照。我们使用一种分类器来评估个体表现以及认知测试、脑脊液生物标志物和自动磁共振成像特征组合在痴呆类型两两鉴别中的准确性。
认知测试在区分任何类型的痴呆与对照方面表现良好。脑脊液对识别阿尔茨海默病的贡献最大，而磁共振成像特征有助于区分血管性痴呆、路易体痴呆和额颞叶痴呆。联合诊断测试提高了准确性，平衡准确率在78%至97%之间。
不同的诊断测试在痴呆症的鉴别诊断中具有各自独特的作用。我们的结果表明，联合不同的诊断测试可能会进一步提高准确性。
