MaltSci 麦伴科研

Appearance

文献精选 > 高引权威"阿尔茨海默病"文献

The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. ​

文献信息 ​

DOI10.1016/j.jalz.2011.03.005
PMID21514250
期刊Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子11.1
JCR 分区Q1
发表年份2011
被引次数6970
关键词阿尔茨海默病, 痴呆诊断, 生物标志物
文献类型Consensus Development Conference, NIH, Journal Article, Research Support, Non-U.S. Gov't
ISSN1552-5260
页码263-9
期号7(3)
作者Guy M McKhann, David S Knopman, Howard Chertkow, Bradley T Hyman, Clifford R Jack, Claudia H Kawas, William E Klunk, Walter J Koroshetz, Jennifer J Manly, Richard Mayeux, Richard C Mohs, John C Morris, Martin N Rossor, Philip Scheltens, Maria C Carrillo, Bill Thies, Sandra Weintraub, Creighton H Phelps

一句话小结 ​

该工作组对1984年阿尔茨海默病（AD）痴呆的诊断标准进行了修订，以提高其在普通医疗和专业研究中的适用性，保留并重新定义了“可能性AD痴呆”概念，并纳入了生物标志物证据，以增强诊断的特异性。此研究为未来AD痴呆的临床诊断和生物标志物的验证提供了重要基础。

在麦伴科研 (maltsci.com) 搜索更多文献 ​

阿尔茨海默病 · 痴呆诊断 · 生物标志物

摘要 ​

美国国立衰老研究所和阿尔茨海默病协会委托一个工作组对1984年阿尔茨海默病（AD）痴呆的诊断标准进行修订。该工作组旨在确保修订后的标准足够灵活，以便既能为没有神经心理测试、高级影像学和脑脊液检测的普通医疗提供者所用，又能为能够使用这些工具的专门研究人员和临床试验研究者所用。我们提出了针对各类痴呆和AD痴呆的诊断标准。我们保留了1984年标准中关于可能性AD痴呆的一般框架。基于过去27年的经验，我们对临床诊断标准进行了若干修改。我们还保留了“可能性AD痴呆”这一术语，但以更加聚焦的方式重新定义了它。生物标志物证据也被纳入到可能性和可能性AD痴呆的诊断公式中，以便在研究环境中使用。AD痴呆的核心临床标准将继续作为临床实践中诊断的基石，但生物标志物证据预计将增强AD痴呆诊断的病理生理特异性。未来还有很多工作需要进行，以验证AD痴呆的生物标志物诊断。

英文摘要 ​

The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of revising the 1984 criteria for Alzheimer's disease (AD) dementia. The workgroup sought to ensure that the revised criteria would be flexible enough to be used by both general healthcare providers without access to neuropsychological testing, advanced imaging, and cerebrospinal fluid measures, and specialized investigators involved in research or in clinical trial studies who would have these tools available. We present criteria for all-cause dementia and for AD dementia. We retained the general framework of probable AD dementia from the 1984 criteria. On the basis of the past 27 years of experience, we made several changes in the clinical criteria for the diagnosis. We also retained the term possible AD dementia, but redefined it in a manner more focused than before. Biomarker evidence was also integrated into the diagnostic formulations for probable and possible AD dementia for use in research settings. The core clinical criteria for AD dementia will continue to be the cornerstone of the diagnosis in clinical practice, but biomarker evidence is expected to enhance the pathophysiological specificity of the diagnosis of AD dementia. Much work lies ahead for validating the biomarker diagnosis of AD dementia.

麦伴智能科研服务 ​

智能阅读回答你对文献的任何问题，帮助理解文献中的复杂图表和公式
定位观点定位某个观点在文献中的蛛丝马迹
加入知识库完成数据提取，报告撰写等更多高级知识挖掘功能

主要研究问题 ​

  1. 在修订阿尔茨海默病痴呆的诊断标准时，考虑了哪些新兴的生物标志物，它们如何影响诊断的准确性？
  2. 除了临床标准外，是否还有其他方法可以提高阿尔茨海默病痴呆的早期诊断率？
  3. 目前在阿尔茨海默病的研究中，生物标志物的应用有哪些具体案例或研究成果？
  4. 在实际临床中，如何平衡使用传统诊断标准与新引入的生物标志物之间的关系？
  5. 对于非专业医疗提供者，如何有效地理解和应用这些新的诊断推荐标准？

核心洞察 ​

研究背景和目的 ​

阿尔茨海默病（AD）是导致老年痴呆的主要原因，准确的诊断对临床治疗和研究至关重要。1984年，国家神经疾病和中风研究所（NINCDS）和阿尔茨海默病及相关疾病协会（ADRDA）制定了AD的诊断标准，但随着对疾病认识的加深，这些标准亟需更新。本文旨在修订AD痴呆的诊断标准，以便在临床和研究中更好地应用。

主要方法/材料/实验设计 ​

研究采用了文献回顾和专家共识的方法，结合临床经验和现代生物标志物的应用，提出了新的AD诊断标准。以下是研究的技术路线：

Mermaid diagram

关键结果和发现 ​

  1. 新诊断标准：修订后的标准包括“可能AD痴呆”和“确定性AD痴呆”两个主要分类，并结合了生物标志物的使用。
  2. 临床标准：AD痴呆的核心临床标准强调症状的逐渐加重，且主要认知缺陷可能表现为记忆障碍或非记忆障碍（如语言、空间认知等）。
  3. 生物标志物的整合：纳入了脑内淀粉样蛋白沉积和神经损伤的生物标志物，以增强诊断的特异性。

主要结论/意义/创新性 ​

新标准旨在为临床医生和研究人员提供更灵活和实用的诊断工具，能够在不同的医疗环境中有效应用。生物标志物的整合提高了对AD病理过程的认识，虽然目前不建议在常规诊断中使用生物标志物，但在研究和临床试验中具有重要意义。

研究局限性和未来方向 ​

  1. 局限性：目前生物标志物的标准化和可及性仍存在问题，限制了其在临床中的广泛应用。
  2. 未来方向：未来的研究需要进一步验证新标准的有效性，并探索生物标志物在早期诊断和疾病监测中的应用潜力。同时，应加强对AD不同表型的理解，以便更好地制定个性化治疗方案。

参考文献 ​

  1. Abeta amyloid and glucose metabolism in three variants of primary progressive aphasia. - Gil D Rabinovici;William J Jagust;Ansgar J Furst;Jennifer M Ogar;Caroline A Racine;Elizabeth C Mormino;James P O'Neil;Rayhan A Lal;Nina F Dronkers;Bruce L Miller;Maria Luisa Gorno-Tempini - Annals of neurology (2008)
  2. Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. - D Neary;J S Snowden;L Gustafson;U Passant;D Stuss;S Black;M Freedman;A Kertesz;P H Robert;M Albert;K Boone;B L Miller;J Cummings;D F Benson - Neurology (1998)
  3. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. - G C Román;T K Tatemichi;T Erkinjuntti;J L Cummings;J C Masdeu;J H Garcia;L Amaducci;J M Orgogozo;A Brun;A Hofman - Neurology (1993)
  4. Classification of primary progressive aphasia and its variants. - M L Gorno-Tempini;A E Hillis;S Weintraub;A Kertesz;M Mendez;S F Cappa;J M Ogar;J D Rohrer;S Black;B F Boeve;F Manes;N F Dronkers;R Vandenberghe;K Rascovsky;K Patterson;B L Miller;D S Knopman;J R Hodges;M M Mesulam;M Grossman - Neurology (2011)
  5. Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. - D S Knopman;S T DeKosky;J L Cummings;H Chui;J Corey-Bloom;N Relkin;G W Small;B Miller;J C Stevens - Neurology (2001)
  6. Clinical, pathological, and biochemical spectrum of Alzheimer disease associated with PS-1 mutations. - Alberto Lleó;Oksana Berezovska;John H Growdon;Bradley T Hyman - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry (2004)
  7. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. - I G McKeith;D W Dickson;J Lowe;M Emre;J T O'Brien;H Feldman;J Cummings;J E Duda;C Lippa;E K Perry;D Aarsland;H Arai;C G Ballard;B Boeve;D J Burn;D Costa;T Del Ser;B Dubois;D Galasko;S Gauthier;C G Goetz;E Gomez-Tortosa;G Halliday;L A Hansen;J Hardy;T Iwatsubo;R N Kalaria;D Kaufer;R A Kenny;A Korczyn;K Kosaka;V M Y Lee;A Lees;I Litvan;E Londos;O L Lopez;S Minoshima;Y Mizuno;J A Molina;E B Mukaetova-Ladinska;F Pasquier;R H Perry;J B Schulz;J Q Trojanowski;M Yamada; - Neurology (2005)
  8. Decreased cerebrospinal fluid Abeta(42) correlates with brain atrophy in cognitively normal elderly. - Anne M Fagan;Denise Head;Aarti R Shah;Daniel Marcus;Mark Mintun;John C Morris;David M Holtzman - Annals of neurology (2009)
  9. Hypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade. - Clifford R Jack;David S Knopman;William J Jagust;Leslie M Shaw;Paul S Aisen;Michael W Weiner;Ronald C Petersen;John Q Trojanowski - The Lancet. Neurology (2010)
  10. Diagnostic criteria for the behavioral variant of frontotemporal dementia (bvFTD): current limitations and future directions. - Katya Rascovsky;John R Hodges;Christopher M Kipps;Julene K Johnson;William W Seeley;Mario F Mendez;David Knopman;Andrew Kertesz;Marsel Mesulam;David P Salmon;Douglas Galasko;Tiffany W Chow;Charles Decarli;Argye Hillis;Keith Josephs;Joel H Kramer;Sandra Weintraub;Murray Grossman;Maria-Luisa Gorno-Tempini;Bruce M Miller - Alzheimer disease and associated disorders (2007)

引用本文的文献 ​

  1. PET amyloid imaging as a tool for early diagnosis and identifying patients at risk for progression to Alzheimer's disease. - Michael J Pontecorvo;Mark A Mintun - Alzheimer's research & therapy (2011)
  2. Toward defining the preclinical stages of Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. - Reisa A Sperling;Paul S Aisen;Laurel A Beckett;David A Bennett;Suzanne Craft;Anne M Fagan;Takeshi Iwatsubo;Clifford R Jack;Jeffrey Kaye;Thomas J Montine;Denise C Park;Eric M Reiman;Christopher C Rowe;Eric Siemers;Yaakov Stern;Kristine Yaffe;Maria C Carrillo;Bill Thies;Marcelle Morrison-Bogorad;Molly V Wagster;Creighton H Phelps - Alzheimer's & dementia : the journal of the Alzheimer's Association (2011)
  3. The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. - Marilyn S Albert;Steven T DeKosky;Dennis Dickson;Bruno Dubois;Howard H Feldman;Nick C Fox;Anthony Gamst;David M Holtzman;William J Jagust;Ronald C Petersen;Peter J Snyder;Maria C Carrillo;Bill Thies;Creighton H Phelps - Alzheimer's & dementia : the journal of the Alzheimer's Association (2011)
  4. Neuroimaging markers for the prediction and early diagnosis of Alzheimer's disease dementia. - Michael Ewers;Reisa A Sperling;William E Klunk;Michael W Weiner;Harald Hampel - Trends in neurosciences (2011)
  5. Progress in Alzheimer's disease. - Daniela Galimberti;Elio Scarpini - Journal of neurology (2012)
  6. Role of cerebrospinal fluid and plasma biomarkers in the diagnosis of neurodegenerative disorders and mild cognitive impairment. - Luis F Gonzalez-Cuyar;Joshua A Sonnen;Kathleen S Montine;C Dirk Keene;Thomas J Montine - Current neurology and neuroscience reports (2011)
  7. Perspective: in search of biomarkers. - Neil S Buckholtz - Nature (2011)
  8. Functional network disruption in the degenerative dementias. - Michela Pievani;Willem de Haan;Tao Wu;William W Seeley;Giovanni B Frisoni - The Lancet. Neurology (2011)
  9. Steps to standardization and validation of hippocampal volumetry as a biomarker in clinical trials and diagnostic criterion for Alzheimer's disease. - Clifford R Jack;Frederik Barkhof;Matt A Bernstein;Marc Cantillon;Patricia E Cole;Charles Decarli;Bruno Dubois;Simon Duchesne;Nick C Fox;Giovanni B Frisoni;Harald Hampel;Derek L G Hill;Keith Johnson;Jean-François Mangin;Philip Scheltens;Adam J Schwarz;Reisa Sperling;Joyce Suhy;Paul M Thompson;Michael Weiner;Norman L Foster - Alzheimer's & dementia : the journal of the Alzheimer's Association (2011)
  10. Biomarkers in Alzheimer's disease. - Mario Riverol;Oscar L López - Frontiers in neurology (2011)

... (6960 更多 篇文献)

© 2025 MaltSci 麦伴科研 - 我们用人工智能技术重塑科研