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寻找一种方便的方法来检测阿尔茨海默病的最早迹象之一:脑淀粉样蛋白状态预测的系统评价。

The search for a convenient procedure to detect one of the earliest signs of Alzheimer's disease: A systematic review of the prediction of brain amyloid status.

机构信息

Department of Veterans Affairs Medical Center, Northern California Institute for Research and Education, San Francisco, California, USA.

Department of Veterans Affairs Medical Center, Center for Imaging and Neurodegenerative Diseases, San Francisco, California, USA.

出版信息

Alzheimers Dement. 2021 May;17(5):866-887. doi: 10.1002/alz.12253. Epub 2021 Feb 13.

Abstract

INTRODUCTION

Convenient, cost-effective tests for amyloid beta (Aβ) are needed to identify those at higher risk for developing Alzheimer's disease (AD). This systematic review evaluates recent models that predict dichotomous Aβ. (PROSPERO: CRD42020144734).

METHODS

We searched Embase and identified 73 studies from 29,581 for review. We assessed study quality using established tools, extracted information, and reported results narratively.

RESULTS

We identified few high-quality studies due to concerns about Aβ determination and analytical issues. The most promising convenient, inexpensive classifiers consist of age, apolipoprotein E genotype, cognitive measures, and/or plasma Aβ. Plasma Aβ may be sufficient if pre-analytical variables are standardized and scalable assays developed. Some models lowered costs associated with clinical trial recruitment or clinical screening.

DISCUSSION

Conclusions about models are difficult due to study heterogeneity and quality. Promising prediction models used demographic, cognitive/neuropsychological, imaging, and plasma Aβ measures. Further studies using standardized Aβ determination, and improved model validation are required.

摘要

简介

需要方便且具有成本效益的淀粉样蛋白β(Aβ)检测来识别那些具有更高患阿尔茨海默病(AD)风险的人群。本系统评价评估了预测二分类 Aβ的最新模型。(PROSPERO:CRD42020144734)。

方法

我们检索了 Embase,并从 29581 项研究中筛选出 73 项进行综述。我们使用既定工具评估了研究质量,提取了信息,并进行了叙述性报告。

结果

由于对 Aβ测定和分析问题的担忧,我们仅确定了少数高质量的研究。最有前途的方便、廉价的分类器包括年龄、载脂蛋白 E 基因型、认知测量和/或血浆 Aβ。如果可以标准化预分析变量并开发可扩展的检测方法,那么血浆 Aβ可能就足够了。一些模型降低了临床试验招募或临床筛查的相关成本。

讨论

由于研究的异质性和质量,很难得出有关模型的结论。有前途的预测模型使用了人口统计学、认知/神经心理学、影像学和血浆 Aβ测量。需要进一步使用标准化的 Aβ测定方法和改进的模型验证进行研究。

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