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Application of Cerebrospinal Fluid AT(N) Framework on the Diagnosis of AD and Related Cognitive Disorders in Chinese Han Population

BACKGROUND: Studies concerning the impact of the AT(N) framework on diagnostic capability in the dementia population are lacking. We aimed to explore the diagnostic application of CSF AT(N) framework in clinical routines of Alzheimer’s disease (AD) as well as differential diagnosis of other cognitiv...

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Autores principales: Ye, Ling-Qi, Gao, Pei-Rong, Zhang, Yan-Bin, Cheng, Hong-Rong, Tao, Qing-Qing, Wu, Zhi-Ying, Li, Hong-Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7910151/
https://www.ncbi.nlm.nih.gov/pubmed/33654388
http://dx.doi.org/10.2147/CIA.S294756
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author Ye, Ling-Qi
Gao, Pei-Rong
Zhang, Yan-Bin
Cheng, Hong-Rong
Tao, Qing-Qing
Wu, Zhi-Ying
Li, Hong-Lei
author_facet Ye, Ling-Qi
Gao, Pei-Rong
Zhang, Yan-Bin
Cheng, Hong-Rong
Tao, Qing-Qing
Wu, Zhi-Ying
Li, Hong-Lei
author_sort Ye, Ling-Qi
collection PubMed
description BACKGROUND: Studies concerning the impact of the AT(N) framework on diagnostic capability in the dementia population are lacking. We aimed to explore the diagnostic application of CSF AT(N) framework in clinical routines of Alzheimer’s disease (AD) as well as differential diagnosis of other cognitive diseases in the Chinese Han population. PATIENTS AND METHODS: A total of 137 patients with cognitive disorders received CSF tests of Aβ(42), t-tau and p-tau(181). Their CSF biomarker results were categorized and interpreted by the AT(N) framework. Neurologists provided a diagnosis both pre- and post-CSF biomarker disclosure with corresponding diagnostic confidence. RESULTS: The total initial diagnosis included 79 patients with AD and 58 patients with non-AD (NAD). The results of CSF biomarkers led to a diagnostic change of 28% in the cohort. Approximately 81.5% (n=53) of 65 patients whose CSF biomarker showed an underlying AD pathology were finally diagnosed as AD, with an increase of 17.5% in diagnostic confidence. Thirty-seven CSF results indicating NAD pathologic changes contributed to an exclusion of AD in 56.8% (n=21) of the patients along with a modest increase of 9.8% in average confidence. Thirty-five patients with normal CSF biomarkers maintained the diagnosis of NAD in 68.6% (n=24) of the group, leading to a slight elevation of 7.6% in confidence. CONCLUSION: We found that the presence of amyloid pathology (A+) is contributable to diagnosing AD and improving confidence. On occasion of negative amyloid pathology (A-), with or without tau pathology, gaining uncertainty of the primary AD diagnosis would diminish the corresponding confidence. To the best of our knowledge, this is the first study performed in the Chinese Han population with cognitive disorders that explores the clinical capability of CSF AT(N) framework in a quantitative way.
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spelling pubmed-79101512021-03-01 Application of Cerebrospinal Fluid AT(N) Framework on the Diagnosis of AD and Related Cognitive Disorders in Chinese Han Population Ye, Ling-Qi Gao, Pei-Rong Zhang, Yan-Bin Cheng, Hong-Rong Tao, Qing-Qing Wu, Zhi-Ying Li, Hong-Lei Clin Interv Aging Original Research BACKGROUND: Studies concerning the impact of the AT(N) framework on diagnostic capability in the dementia population are lacking. We aimed to explore the diagnostic application of CSF AT(N) framework in clinical routines of Alzheimer’s disease (AD) as well as differential diagnosis of other cognitive diseases in the Chinese Han population. PATIENTS AND METHODS: A total of 137 patients with cognitive disorders received CSF tests of Aβ(42), t-tau and p-tau(181). Their CSF biomarker results were categorized and interpreted by the AT(N) framework. Neurologists provided a diagnosis both pre- and post-CSF biomarker disclosure with corresponding diagnostic confidence. RESULTS: The total initial diagnosis included 79 patients with AD and 58 patients with non-AD (NAD). The results of CSF biomarkers led to a diagnostic change of 28% in the cohort. Approximately 81.5% (n=53) of 65 patients whose CSF biomarker showed an underlying AD pathology were finally diagnosed as AD, with an increase of 17.5% in diagnostic confidence. Thirty-seven CSF results indicating NAD pathologic changes contributed to an exclusion of AD in 56.8% (n=21) of the patients along with a modest increase of 9.8% in average confidence. Thirty-five patients with normal CSF biomarkers maintained the diagnosis of NAD in 68.6% (n=24) of the group, leading to a slight elevation of 7.6% in confidence. CONCLUSION: We found that the presence of amyloid pathology (A+) is contributable to diagnosing AD and improving confidence. On occasion of negative amyloid pathology (A-), with or without tau pathology, gaining uncertainty of the primary AD diagnosis would diminish the corresponding confidence. To the best of our knowledge, this is the first study performed in the Chinese Han population with cognitive disorders that explores the clinical capability of CSF AT(N) framework in a quantitative way. Dove 2021-02-22 /pmc/articles/PMC7910151/ /pubmed/33654388 http://dx.doi.org/10.2147/CIA.S294756 Text en © 2021 Ye et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Ye, Ling-Qi
Gao, Pei-Rong
Zhang, Yan-Bin
Cheng, Hong-Rong
Tao, Qing-Qing
Wu, Zhi-Ying
Li, Hong-Lei
Application of Cerebrospinal Fluid AT(N) Framework on the Diagnosis of AD and Related Cognitive Disorders in Chinese Han Population
title Application of Cerebrospinal Fluid AT(N) Framework on the Diagnosis of AD and Related Cognitive Disorders in Chinese Han Population
title_full Application of Cerebrospinal Fluid AT(N) Framework on the Diagnosis of AD and Related Cognitive Disorders in Chinese Han Population
title_fullStr Application of Cerebrospinal Fluid AT(N) Framework on the Diagnosis of AD and Related Cognitive Disorders in Chinese Han Population
title_full_unstemmed Application of Cerebrospinal Fluid AT(N) Framework on the Diagnosis of AD and Related Cognitive Disorders in Chinese Han Population
title_short Application of Cerebrospinal Fluid AT(N) Framework on the Diagnosis of AD and Related Cognitive Disorders in Chinese Han Population
title_sort application of cerebrospinal fluid at(n) framework on the diagnosis of ad and related cognitive disorders in chinese han population
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7910151/
https://www.ncbi.nlm.nih.gov/pubmed/33654388
http://dx.doi.org/10.2147/CIA.S294756
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