Alzheimer's & dementia : the journal of the Alzheimer's Association · 2016
Recommendations for cerebrospinal fluid Alzheimer's disease biomarkers in the diagnostic evaluation of mild cognitive impairment.
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Herukka Sanna-Kaisa, Simonsen Anja Hviid, Andreasen Niels, Baldeiras Ines, Bjerke Maria, Blennow Kaj, Engelborghs Sebastiaan, Frisoni Giovanni B, Gabryelewicz Tomasz, Galluzzi Samantha, Handels Ron, Kramberger Milica G, Kulczyńska Agnieszka, Molinuevo Jose Luis, Mroczko Barbara, Nordberg Agneta, Oliveira Catarina Resende, Otto Markus, Rinne Juha O, Rot Uroš, Saka Esen, Soininen Hilkka, Struyfs Hanne, Suardi Silvia, Visser Pieter Jelle, Winblad Bengt, Zetterberg Henrik, Waldemar Gunhild
Аннотация
This article presents recommendations, based on the Grading of Recommendations, Assessment, Development, and Evaluation method, for the clinical application of cerebrospinal fluid (CSF) amyloid-β1-42, tau, and phosphorylated tau in the diagnostic evaluation of patients with mild cognitive impairment (MCI). The recommendations were developed by a multidisciplinary working group and based on the available evidence and consensus from focused group discussions for 1) prediction of clinical progression to Alzheimer's disease (AD) dementia, 2) cost-effectiveness, 3) interpretation of results, and 4) patient counseling. The working group recommended using CSF AD biomarkers in the diagnostic workup of MCI patients, after prebiomarker counseling, as an add-on to clinical evaluation to predict functional decline or conversion to AD dementia and to guide disease management. Because of insufficient evidence, it was uncertain whether CSF AD biomarkers outperform imaging biomarkers. Furthermore, the working group provided recommendations for interpretation of ambiguous CSF biomarker results and for pre- and post-biomarker counseling.