Gramkow Mathias Holsey, Clemmensen Frederikke Kragh, Sjælland Nikolai Sulkjær, Waldemar Gunhild, Hasselbalch Steen Gregers, Frederiksen Kristian Steen
Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet Copenhagen Denmark.
Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark.
Alzheimers Dement (Amst). 2024 Jul 31;16(3):e12628. doi: 10.1002/dad2.12628. eCollection 2024 Jul-Sep.
Easily applied diagnostic tools such as digital biomarkers for Alzheimer's disease (AD) are urgently needed due to the recent approval of disease-modifying therapies. We aimed to determine the diagnostic performance of hand-held, quantitative light reflex pupillometry (qLRP) in patients with AD in a proof-of-concept, cross-sectional study. Participants underwent qLRP at a university memory clinic from August 2022 to October 2023. We fitted multivariable logistic regression models with qLRP, sex, and age as predictors evaluated with area under the receiver operating characteristics curve (AUROC). In total, 107 patients with AD, 44 patients with mixed AD and vascular cognitive dysfunction (VCD), 53 patients with dementia with Lewy bodies (DLB), and 50 healthy controls (HCs) were included. Our diagnostic models showed similar discriminatory ability (AUROC range 0.74-0.81) when distinguishing patients with AD from HCs and other dementias. The qLRP seems promising as a bedside digital biomarker to aid in diagnosing AD.
We demonstrated the diagnostic performance of qLRP in Alzheimer's disease.The diagnostic models were robust in sensitivity analyses.qLRP may assist in the bedside diagnostic evaluation of Alzheimer's disease.
由于疾病修饰疗法最近获得批准，迫切需要易于应用的诊断工具，如用于阿尔茨海默病（AD）的数字生物标志物。在一项概念验证性横断面研究中，我们旨在确定手持式定量光反射瞳孔测量法（qLRP）在AD患者中的诊断性能。参与者于2022年8月至2023年10月在大学记忆诊所接受qLRP检查。我们拟合了以qLRP、性别和年龄作为预测因子的多变量逻辑回归模型，并通过受试者操作特征曲线下面积（AUROC）进行评估。总共纳入了107例AD患者、44例AD合并血管性认知功能障碍（VCD）患者、53例路易体痴呆（DLB）患者和50例健康对照（HCs）。当区分AD患者与HCs及其他痴呆患者时，我们的诊断模型显示出相似的鉴别能力（AUROC范围为0.74 - 0.81）。qLRP作为一种床边数字生物标志物，在辅助诊断AD方面似乎很有前景。
我们展示了qLRP在阿尔茨海默病中的诊断性能。诊断模型在敏感性分析中表现稳健。qLRP可能有助于阿尔茨海默病的床边诊断评估。
