Challenges associated with biomarker-based classification systems for Alzheimer's disease.

TitleChallenges associated with biomarker-based classification systems for Alzheimer's disease.
Publication TypeJournal Article
Year of Publication2018
AuthorsIllán-Gala I, Pegueroles J, Montal V, Vilaplana E, Carmona-Iragui M, Alcolea D, Dickerson BC, Sánchez-Valle R, de Leon MJ, Blesa R, Lleó A, Fortea J
JournalAlzheimers Dement (Amst)
Volume10
Pagination346-357
Date Published2018
ISSN2352-8729
Abstract

INTRODUCTION: We aimed to evaluate the consistency of the A/T/N classification system.

METHODS: We included healthy controls, mild cognitive impairment, and dementia patients from Alzheimer's disease Neuroimaging Initiative. We assessed subject classification consistency with different biomarker combinations and the agreement and correlation between biomarkers.

RESULTS: Subject classification discordance ranged from 12.2% to 44.5% in the whole sample; 17.3%-46.4% in healthy controls; 11.9%-46.5% in mild cognitive impairment, and 1%-35.7% in dementia patients. Amyloid, but not neurodegeneration biomarkers, showed good agreement both in the whole sample and in the clinical subgroups. Amyloid biomarkers were correlated in the whole sample, but not along the Alzheimer's disease continuum (as defined by a positive amyloid positron emission tomography). Neurodegeneration biomarkers were poorly correlated both in the whole sample and along the Alzheimer's disease continuum. The relationship between biomarkers was stage-dependent.

DISCUSSION: Our findings suggest that the current A/T/N classification system does not achieve the required consistency to be used in the clinical setting.

DOI10.1016/j.dadm.2018.03.004
Alternate JournalAlzheimers Dement (Amst)
PubMed ID30175226
PubMed Central IDPMC6114028
Grant ListP30 AG008051 / AG / NIA NIH HHS / United States
R01 AG012101 / AG / NIA NIH HHS / United States
R01 AG022374 / AG / NIA NIH HHS / United States
Related Institute: 
Brain Health Imaging Institute (BHII)

Weill Cornell Medicine
Department of Radiology
525 East 68th Street New York, NY 10065