Clinical applicability of diagnostic biomarkers in early onset cognitive impairment.

BACKGROUND: Several diagnostic biomarkers are currently available for its clinical use in early onset cognitive impairment. The decision of which biomarker is used in each patient depends on several factors such as its predictive value or tolerability.

METHODS: Forty subjects with early onset cognitive complaints (<65 years): 26 with Alzheimer's disease (AD), 5 with fronto-temporal dementia and 9 with non-neurodegenerative disorder diagnostic suspicion. Clinical, neuropsychological evaluation, lumbar puncture (LP) for cerebrospinal fluid (CSF) AD core biochemical markers determination, medial temporal atrophy evaluation on MRI, amyloid-PET and FDG-PET were performed. Neurologists provided pre and post biomarkers diagnosis, its diagnostic confidence and clinical/therapeutic management. Patients scored their tolerability to each procedure.

RESULTS: CSF biomarkers and amyloid-PET increased diagnostic confidence in AD (77.4% to 86.2% after CSF, 92.4% after amyloid-PET, p<0.01) and non-neurodegenerative condition (53.6% to 75% after CSF, 95% after amyloid-PET, p<0.05). Biomarkers results led to diagnostic (32.5%) and treatment (32.5%) changes. All tests were well tolerated.

CONCLUSIONS: Biomarkers procedures are well tolerated and they have an important diagnostic/ therapeutic impact on the early onset cognitive impairment. This article is protected by copyright. All rights reserved.