临床阿尔茨海默病诊断与尸检神经病理学特征的一致性。
Concordance of Clinical Alzheimer Diagnosis and Neuropathological Features at Autopsy.
机构信息
Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, Washington.
Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research Sponsored by the National Cancer Institute, Frederick, Maryland.
出版信息
J Neuropathol Exp Neurol. 2020 May 1;79(5):465-473. doi: 10.1093/jnen/nlaa014.
Abstract
It remains unclear what clinical features inform the accuracy of a clinical diagnosis of Alzheimer disease (AD). Data were obtained from the National Alzheimer's Coordinating Center to compare clinical and neuropathologic features among participants who did or did not have Alzheimer disease neuropathologic changes (ADNC) at autopsy. Participants (1854) had a clinical Alzheimer dementia diagnosis and ADNC at autopsy (Confirmed-AD), 204 participants had an AD diagnosis and no ADNC (AD-Mimics), and 253 participants had no AD diagnosis and ADNC (Unidentified-AD). Compared to Confirmed-AD participants, AD-Mimics had less severe cognitive impairment, while Unidentified-AD participants displayed more parkinsonian signs, depression, and behavioral problems. This study highlights the importance of developing a complete panel of biomarkers as a tool to inform clinical diagnoses, as clinical phenotypes that are typically associated with diseases other than AD may result in inaccurate diagnoses.
摘要
目前尚不清楚哪些临床特征能为阿尔茨海默病（AD）的临床诊断提供准确性。本研究的数据来自美国国家阿尔茨海默病协调中心，旨在比较尸检时存在或不存在阿尔茨海默病神经病理改变（ADNC）的参与者的临床和神经病理特征。参与者（1854 名）有临床阿尔茨海默病痴呆诊断和 ADNC（确诊 AD），204 名参与者有 AD 诊断但无 ADNC（AD 模拟物），253 名参与者无 AD 诊断但有 ADNC（未识别 AD）。与确诊 AD 参与者相比，AD 模拟物的认知障碍程度较轻，而未识别 AD 参与者表现出更多的帕金森症状、抑郁和行为问题。这项研究强调了开发完整的生物标志物组作为辅助临床诊断工具的重要性，因为与 AD 以外的疾病相关的临床表型可能导致诊断不准确。
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