Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria

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• 作者：Prof Bruno Dubois ; MD^a ; ^b ; ^{bruno.dubois@psl.aphp.fr" class="auth_mail} ; Prof Howard H Feldman ; MD^c ; Claudia Jacova ; PhD^d ; Prof Harald Hampel ; MD^a ; ^b ; José ; Luis Molinuevo ; MD^e ; ^f ; Kaj Blennow ; MD^g ; Prof Steven T DeKosky ; MD^h ; Prof Serge Gauthier ; MDⁱ ; Prof Dennis Selkoe ; MD^j ; Randall Bateman ; MD^k ; Stefano Cappa ; MD^l ; ^m ; Sebastian Crutch ; PhDⁿ ; ^o ; Sebastiaan Engelborghs ; MD^p ; ^q ; Prof Giovanni B Frisoni ; MD^r ; ^s ; ^t ; Nick C Fox ; MDⁿ ; Prof Douglas Galasko ; MD^u ; Marie-Odile Habert ; MD^v ; ^w ; Gregory A Jicha ; MD^x ; Agneta Nordberg ; MD^y ; Prof Florence Pasquier ; MD^z ; ^aa ; Gil Rabinovici ; MD^ab ; Prof Philippe Robert ; MD^ac ; Christopher Rowe ; MD^ad ; Prof Stephen Salloway ; MD^ae ; Prof Marie Sarazin ; MD^af ; ^ag ; Sté ; phane Epelbaum ; MD^a ; ^b ; Leonardo C de Souza ; MD^a ; ^b ; ^ah ; Prof Bruno Vellas ; MD^ai ; Pieter J Visser ; MD^aj ; ^ak ; Prof Lon Schneider ; MD^al ; Prof Yaakov Stern ; PhD^am ; Prof Philip Scheltens ; MD^an ; Prof Jeffrey L Cummings ; MD^ao
• 刊名：Lancet Neurology
• 出版年：June 2014
• 年：2014
• 卷：13
• 期：6
• 页码：614-629
• 全文大小：290 K

文摘

In the past 8 years, both the International Working Group (IWG) and the US National Institute on Aging–Alzheimer's Association have contributed criteria for the diagnosis of Alzheimer's disease (AD) that better define clinical phenotypes and integrate biomarkers into the diagnostic process, covering the full staging of the disease. This Position Paper considers the strengths and limitations of the IWG research diagnostic criteria and proposes advances to improve the diagnostic framework. On the basis of these refinements, the diagnosis of AD can be simplified, requiring the presence of an appropriate clinical AD phenotype (typical or atypical) and a pathophysiological biomarker consistent with the presence of Alzheimer's pathology. We propose that downstream topographical biomarkers of the disease, such as volumetric MRI and fluorodeoxyglucose PET, might better serve in the measurement and monitoring of the course of disease. This paper also elaborates on the specific diagnostic criteria for atypical forms of AD, for mixed AD, and for the preclinical states of AD.