ABSTRACT
BACKGROUND AND PURPOSE: Several diagnostic biomarkers are currently available for clinical use in early-onset cognitive impairment. The decision on which biomarker is used in each patient depends on several factors such as its predictive value or tolerability. METHODS: There were a total of 40 subjects with early-onset cognitive complaints (<65 years of age): 26 with Alzheimer's disease (AD), five with frontotemporal dementia and nine with diagnostic suspicion of non-neurodegenerative disorder. Clinical and neuropsychological evaluation, lumbar puncture for cerebrospinal fluid (CSF) AD core biochemical marker determination, medial temporal atrophy evaluation on magnetic resonance imaging, amyloid-positron emission tomography (PET) and 18 F-fluorodeoxyglucose-PET were performed. Neurologists provided pre- and post-biomarker diagnosis, together with diagnostic confidence and clinical/therapeutic management. Patients scored the tolerability of each procedure. RESULTS: Cerebrospinal fluid biomarkers and amyloid-PET increased diagnostic confidence in AD (77.4%-86.2% after CSF, 92.4% after amyloid-PET, P < 0.01) and non-neurodegenerative conditions (53.6%-75% after CSF, 95% after amyloid-PET, P < 0.05). Biomarker results led to diagnostic (32.5%) and treatment (32.5%) changes. All tests were well tolerated. CONCLUSIONS: Biomarker procedures are well tolerated and have an important diagnostic/therapeutic impact on early-onset cognitive impairment.
Subject(s)
Alzheimer Disease/diagnosis , Cognitive Dysfunction/diagnosis , Frontotemporal Dementia/diagnosis , Alzheimer Disease/cerebrospinal fluid , Alzheimer Disease/diagnostic imaging , Amyloid beta-Peptides/cerebrospinal fluid , Biomarkers/cerebrospinal fluid , Cognitive Dysfunction/cerebrospinal fluid , Cognitive Dysfunction/diagnostic imaging , Female , Frontotemporal Dementia/cerebrospinal fluid , Frontotemporal Dementia/diagnostic imaging , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neuropsychological Tests , Positron-Emission Tomography/methodsABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Aphasia/etiology , Aphasia/diagnosis , Hepatic Encephalopathy/complications , Portasystemic Shunt, Surgical/methods , Conduct Disorder/complications , Unconsciousness/diagnosis , Dyskinesias/diagnosis , Aphasia/therapy , Cerebral Cortex/diagnostic imaging , Cerebral Cortex/injuriesABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Behcet Syndrome/complications , Arteriovenous Fistula/diagnosis , Headache/etiology , Angiography , Venous Thrombosis/diagnosisABSTRACT
No disponible
