Turner R Scott, Stubbs Terry, Davies Don A, Albensi Benedict C
Department of Neurology, Georgetown University, Washington, DC, United States.
ActivMed, Practices & Research, Methuen, MA, United States.
Front Neurol. 2020 Jun 5;11:496. doi: 10.3389/fneur.2020.00496. eCollection 2020.
Dementia is an umbrella term-caused by a large number of specific diagnoses, including several neurodegenerative disorders. Alzheimer's disease (AD) is now the most common cause of dementia in advanced countries, while dementia due to neurosyphilis was the leading cause a century ago. Many challenges remain for diagnosing dementia definitively. Some of these include variability of early symptoms and overlap with similar disorders, as well as the possibility of combined, or mixed, etiologies in some cases. Newer technologies, including the incorporation of PET neuroimaging and other biomarkers (genomics and proteomics), are being incorporated into revised diagnostic criteria. However, the application of novel diagnostic methods at clinical sites is plagued by many caveats including availability and access. This review surveys new diagnostic methods as well as remaining challenges-for clinical care and clinical research.
痴呆是一个概括性术语，由大量特定诊断引起，包括几种神经退行性疾病。在发达国家，阿尔茨海默病（AD）现在是痴呆最常见的病因，而一个世纪前，神经梅毒所致痴呆是主要病因。明确诊断痴呆仍存在许多挑战。其中一些挑战包括早期症状的变异性、与类似疾病的重叠，以及在某些情况下病因合并或混合的可能性。包括正电子发射断层扫描（PET）神经成像和其他生物标志物（基因组学和蛋白质组学）在内的新技术正在被纳入修订后的诊断标准。然而，新诊断方法在临床场所的应用受到诸多限制，包括可用性和可及性。本综述调查了新的诊断方法以及临床护理和临床研究中仍然存在的挑战。
