Mirra S S
Department of Pathology and Laboratory Medicine, Veterans Affairs Medical Center, Atlanta, Georgia, USA.
Int Psychogeriatr. 1997;9 Suppl 1:263-8; discussion 269-72. doi: 10.1017/s1041610297004985.
The Consortium to Establish a Registry for Alzheimer's Disease (CERAD), a multicenter longitudinal study, has worked to establish standardized instruments for the evaluation of individuals clinically diagnosed as having Alzheimer's disease (AD). Since its formation in 1986, clinical neuropsychological, neuroimaging, and neuropathology assessment batteries have been developed. The neuropathology protocol not only establishes levels of certainty for the diagnosis of AD, but also facilitates correlations with clinical, genetic, and other data. We find a high rate of diagnostic accuracy: the clinical diagnosis of AD was confirmed in 176 of 201 (87.6%) CERAD dementia subjects. Coexistent vascular lesions, usually infarcts, were found in 32% of these confirmed AD cases, and 23% had coexisting Parkinson's disease (PD) changes (nigral degeneration and Lewy bodies at any site). In the remaining 25 cases (12.4%), neuropathologists attributed the primary cause of dementia to other conditions. In studies comparing neuropathology protocols for AD, several groups have found that the CERAD diagnosis most closely correlates with measures of dementia severity, such as the Mini-Mental State Examination (MMSE). Others have adopted the CERAD neuropathology protocol for multicenter brain banking, citing its relative simplicity and adaptability among laboratories, the experience of many AD centers with the protocol, and its application to other dementing conditions. The CERAD data set and batteries are increasingly used for a wide array of clinical, neuropathological, and genetic studies.
阿尔茨海默病注册协会（CERAD）是一项多中心纵向研究，致力于建立标准化工具，以评估临床诊断为患有阿尔茨海默病（AD）的个体。自1986年成立以来，已经开发了临床神经心理学、神经影像学和神经病理学评估系列。神经病理学方案不仅确定了AD诊断的确定性水平，还促进了与临床、遗传和其他数据的关联。我们发现诊断准确率很高：在201名CERAD痴呆受试者中，有176名（87.6%）的AD临床诊断得到证实。在这些确诊的AD病例中，32%存在共存的血管病变，通常为梗死，23%存在共存的帕金森病（PD）改变（黑质变性和任何部位的路易体）。在其余25例（12.4%）中，神经病理学家将痴呆的主要原因归因于其他情况。在比较AD神经病理学方案的研究中，几个研究小组发现，CERAD诊断与痴呆严重程度的测量指标，如简易精神状态检查表（MMSE），最密切相关。其他研究小组采用CERAD神经病理学方案进行多中心脑库建设，理由是该方案相对简单，在各实验室具有适应性，许多AD中心有该方案的使用经验，且该方案可应用于其他痴呆病症。CERAD数据集和评估系列越来越多地用于广泛的临床、神经病理学和遗传学研究。
