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01-01-2014 | Original Communication

Impact of cerebro-spinal fluid biomarkers of Alzheimer’s disease in clinical practice: a multicentric study

Authors: François Mouton-Liger, David Wallon, Anne-Cécile Troussière, Rachida Yatimi, Julien Dumurgier, Eloi Magnin, Vincent de la Sayette, Emannuelle Duron, Nathalie Philippi, Emilie Beaufils, Audrey Gabelle, Bernard Croisile, Philippe Robert, Florence Pasquier, Didier Hannequin, Jacques Hugon, Claire Paquet

Published in: Journal of Neurology | Issue 1/2014

Abstract

CSF biomarkers of Alzheimer’s disease are well validated in clinical research; however, their pragmatic utility in daily practice is still unappreciated. These biomarkers are used in routine practice according to Health Authority Recommendations. In 604 consecutive patients explored for cognitive disorders, questionnaires were prospectively proposed and filled. Before and after CSF biomarker results, clinicians provided a diagnosis and an estimate of their diagnostic confidence. Analysis has compared the frequency of diagnosis before and after CSF biomarker results using the net reclassification improvement (NRI) method. We have evaluated external validity comparing with data of French Bank National of AD (BNA). A total of 561 patients [Alzheimer’s disease (AD), n = 253; non-AD, n = 308] were included (mean age, 68.6 years; women, 52 %). Clinically suspected diagnosis and CSF results were concordant in 65.2 % of cases. When clinical hypothesis and biological results were discordant, a reclassification occurred in favour of CSF biomarkers results in 76.9 %. The NRI was 39.5 %. In addition, the results show a statistically significant improvement in clinician confidence for their diagnosis. In comparison with BNA data, patients were younger and more frequently diagnosed with AD. Clinicians tend to heavily rely on the CSF AD biomarkers results and are more confident in their diagnoses using CSF AD biomarkers. Thus, these biomarkers appear as a key tool in clinical practice.

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Title: Impact of cerebro-spinal fluid biomarkers of Alzheimer’s disease in clinical practice: a multicentric study
Authors: François Mouton-Liger
David Wallon
Anne-Cécile Troussière
Rachida Yatimi
Julien Dumurgier
Eloi Magnin
Vincent de la Sayette
Emannuelle Duron
Nathalie Philippi
Emilie Beaufils
Audrey Gabelle
Bernard Croisile
Philippe Robert
Florence Pasquier
Didier Hannequin
Jacques Hugon
Claire Paquet
Publication date: 01-01-2014
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 1/2014
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-013-7160-3

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Impact of cerebro-spinal fluid biomarkers of Alzheimer’s disease in clinical practice: a multicentric study

Abstract

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Abstract

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