Clinical, molecular imaging and biomarker concordance in the diagnosis of Alzheimer’s disease and vascular dementia
Venugopalan Y Vishnu, Manish Modi, Jitender Gairolla, Ashok Kumar, Manju Mohanty, Manoj Kumar Goyal, Vivek Lal, Bhagwant Rai Mittal, Sudesh Prabhakar
Abstract
Background
The CSF and plasma biomarkers may help clinicians in differentiating between Alzheimer and Vascular dementia. Apart from biopsy, FDG PET, MRI Brain and clinical examination gives a reliable diagnosis of AD and VaD.
Aims
To evaluate the correlation of molecular imaging (FDG PET brain) with CSF Alzheimer profile and Plasma hemostatic biomarkers in Mild Cognitive Impairment (MCI), Alzheimer’s disease (AD) and Vascular dementia (VaD).
Methods
Neuropsychological assessment, MRI brain, FDG-PET brain, CSF biomarkers of AD (Aβ42 and total tau) and plasma hemostatic biomarkers (Fibrinogen and D dimer) were done for evaluation.
Results
FDG PET Brain, plasma fibrinogen and D dimer were done in 68 patients. CSF biomarkers were done in 46 patients. Clinical-PET discordance was found in 7 patients. One patient of MCI-VaSC had a normal PET study with elevated hemoststic biomarkers. Those with clinical diagnosis of Alzheimer’s disease either had normal hemostatic biomarkers and supporting Alzheimer profile CSF biomarkers where they were done. The discordant vascular group had elevated plasma hemostatic biomarker with normal CSF profile. Even those who were reported as FTD in PET imaging had Alzheimer profile and normal hemostatic factors.
Conclusion
FDG PET brain findings were concordant with the CSF biomarkers (CSF Aβ42, Total tau and Tau/Aβ42 ratio) in Alzheimer’s disease and Haemostatic biomarkers (Plasma Fibrinogen and D dimer) in vascular dementia. In clinical and molecular imaging discordance, biomarkers help in making a reliable diagnosis which favours the clinical assessment.
Full Text:
The CSF and plasma biomarkers may help clinicians in differentiating between Alzheimer and Vascular dementia. Apart from biopsy, FDG PET, MRI Brain and clinical examination gives a reliable diagnosis of AD and VaD.
Aims
To evaluate the correlation of molecular imaging (FDG PET brain) with CSF Alzheimer profile and Plasma hemostatic biomarkers in Mild Cognitive Impairment (MCI), Alzheimer’s disease (AD) and Vascular dementia (VaD).
Methods
Neuropsychological assessment, MRI brain, FDG-PET brain, CSF biomarkers of AD (Aβ42 and total tau) and plasma hemostatic biomarkers (Fibrinogen and D dimer) were done for evaluation.
Results
FDG PET Brain, plasma fibrinogen and D dimer were done in 68 patients. CSF biomarkers were done in 46 patients. Clinical-PET discordance was found in 7 patients. One patient of MCI-VaSC had a normal PET study with elevated hemoststic biomarkers. Those with clinical diagnosis of Alzheimer’s disease either had normal hemostatic biomarkers and supporting Alzheimer profile CSF biomarkers where they were done. The discordant vascular group had elevated plasma hemostatic biomarker with normal CSF profile. Even those who were reported as FTD in PET imaging had Alzheimer profile and normal hemostatic factors.
Conclusion
FDG PET brain findings were concordant with the CSF biomarkers (CSF Aβ42, Total tau and Tau/Aβ42 ratio) in Alzheimer’s disease and Haemostatic biomarkers (Plasma Fibrinogen and D dimer) in vascular dementia. In clinical and molecular imaging discordance, biomarkers help in making a reliable diagnosis which favours the clinical assessment.
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