Biomarker-based diagnosis of cognitive disorders in a case series

Kapaki, Elisabeth; Constantinides, Vasilios C.; Pyrgelis, Efstratios-Stylianos; Paraskevas, Panagiotis G.; Papatriantafyllou, John; Paraskevas, George P.

doi:10.20517/2347-8659.2019.26

Cited by 3 publications

(2 citation statements)

References 39 publications

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“…Atypical clinical presentations of AD are not uncommon and CSF biomarkers seem to offer a useful index for ante mortem identification of most such patients in routine practice, especially in cases mixed with vascular or Lewy-body pathology, and in some atypical presentations such as PPA, CBS, frontal dysexecutive and/or behavioural syndrome or PCA [28,[35][36][37][38][39][40][41][42][43][44][45][46][47][48]. It is unknown whether currently available treatments for AD have the same effectiveness in atypical as in typical amnestic presentations.…”

Section: Discussionmentioning

confidence: 99%

Atypical Presentations of Alzheimer’s Disease: Beyond Amnestic Dementia

Tsantzali¹,

Paraskevas²,

Paraskevas³

et al. 2020

CEI

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Neuropathological and biomarker-based studies indicate that Alzheimer’s disease may sometimes present not with the typical amnestic dementia syndrome of the hippocampal type but with atypical clinical pictures. Atypical presentations include frontal dementia sometimes with additional behavioural component mimicking frontotemporal dementia, logopenic primary progressive aphasia and posterior cortical atrophy, while mixed presentations include patients with additional vascular or Lewy body pathology. More atypical presentations include non-logopenic (semantic, non-fluent agrammatic and unclassifiable) primary progressive aphasia, corticobasal syndrome and cases mixed with normal pressure hydrocephalus. Atypical clinical presentations of Alzheimer’s disease may be more common than previously thought. Cerebrospinal fluid levels of biomarkers such as amyloid beta peptide, hyperphosphorylated tau protein and total tau protein, may offer a useful tool for correct ante mortem identification of such patients, which is likely to affect therapeutic decisions.

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Section: Discussionmentioning

confidence: 99%

Atypical Presentations of Alzheimer’s Disease: Beyond Amnestic Dementia

Tsantzali¹,

Paraskevas²,

Paraskevas³

et al. 2020

CEI

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“…Amyloid beta peptide with 40 amino acids (Aβ 40 ) can also be measured in the CSF, and it is useful in the form of the Aβ 42 /Aβ 40 ratio, which seems to perform diagnostically better than Aβ 42 alone [32]. These biomarkers may be helpful in the recognition and/or differential diagnosis of AD in patients with a typical amnestic presentation as well as in cases with atypical or mixed presentations [33][34][35][36][37][38].…”

Section: The Csf Alzheimer's Disease Profilementioning

confidence: 99%

Cerebrospinal Fluid Biomarkers for Alzheimer’s Disease in the Era of Disease-Modifying Treatments

Paraskevas

Kapaki

2021

Brain Sciences

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Correct in vivo diagnosis of Alzheimer’s disease (AD) helps to avoid administration of disease-modifying treatments in non-AD patients, and allows the possible use of such treatments in clinically atypical AD patients. Cerebrospinal fluid (CSF) biomarkers offer a tool for AD diagnosis. A reduction in CSF β-amyloid (marker of amyloid plaque burden), although compatible with Alzheimer’s pathological change, may also be observed in other dementing disorders, including vascular cognitive disorders due to subcortical small-vessel disease, dementia with Lewy bodies and normal-pressure hydrocephalus. Thus, for the diagnosis of AD, an abnormal result of CSF β-amyloid may not be sufficient, and an increase in phospho-tau (marker of tangle pathology) is also required in order to confirm AD diagnosis in patients with a typical amnestic presentation and reveal underlying AD in patients with atypical or mixed and diagnostically confusing clinical presentations.

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Neuropsychological signs of the neurodegenerative process in Alzheimer’s disease at the stage of mild cognitive impairment

Zhukova,

Kolupaeva,

Zhukova

et al. 2023

Bulletin of Neurology, Psychiatry and Neurosurgery

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Currently, a huge number of works by domestic and foreign authors are devoted to the study of the neuropsychological heterogeneity of Alzheimer’s disease (AD) at the stage of mild cognitive impairment (MCI). The purpose of our study was to study the neuropsychological characteristics of AD at the stage of MCI depending on the timing of manifestation. The study involved 173 patients with asthma at the stage of MCI, of which 65 patients had early onset and 108 patients had late onset. All study participants underwent the Montreal Cognitive Assessment (MoCA), the Free Recall Test with selective cues and immediate recall (FCSRT-IR), the route-following test (drawing paths): part A and B; categorical and phonemic verbal fluency, digit recall (DST). The average age of patients with early onset of asthma was 65.1±0.3 years, with late onset — 78.6±0.5 years. According to the results of the study, it was found that patients with a late form of asthma coped with MoCA worse than a patient with an early form (p=0.043). Patients with late onset AD produced fewer words independently in the FCSRT-IR test compared to patients with early onset (p<0.001). Analysis of DST test performance in forward (p=0.41) and reverse order (p=0.197) did not show significant differences. We found that patients with early AD made more errors (p=0.000) and took longer to complete the route-following test, both parts A and B. There was no significant difference when assessing categorical verbal fluency (p=0.67). At the same time, patients with early onset AD named fewer words when assessing phonemic verbal fluency (p=0.000). The results of our study indicate the need for comprehensive, extensive neuropsychological testing in patients with suspected AD.

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Biomarker-based diagnosis of cognitive disorders in a case series

Cited by 3 publications

References 39 publications

Atypical Presentations of Alzheimer’s Disease: Beyond Amnestic Dementia

Atypical Presentations of Alzheimer’s Disease: Beyond Amnestic Dementia

Cerebrospinal Fluid Biomarkers for Alzheimer’s Disease in the Era of Disease-Modifying Treatments

Neuropsychological signs of the neurodegenerative process in Alzheimer’s disease at the stage of mild cognitive impairment

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