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

Ignacio Illán-Gala, Jordi Pegueroles, Victor Montal, Eduard Vilaplana, María Carmona-Iragui, Daniel Alcolea, Bradford C. Dickerson, Raquel Sánchez-Valle, Mony J. de Leon, Rafael Blesa, Alberto Lleó, Juan Fortea
<span title="">2018</span> <i title="Elsevier BV"> <a target="_blank" rel="noopener" href="" style="color: black;">Alzheimer&#39;s and Dementia: Diagnosis, Assessment and Disease Monitoring</a> </i> &nbsp;
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
more &raquo; ... tive 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 stagedependent. 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. The authors have declared that no conflict of interest exists. The authors I.I.-G. and J.P. contributed equally to this work. 1 Data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc .edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at:
<span class="external-identifiers"> <a target="_blank" rel="external noopener noreferrer" href="">doi:10.1016/j.dadm.2018.03.004</a> <a target="_blank" rel="external noopener" href="">pmid:30175226</a> <a target="_blank" rel="external noopener" href="">pmcid:PMC6114028</a> <a target="_blank" rel="external noopener" href="">fatcat:vd7osmndk5bdpo4dzrpt2oqtye</a> </span>
<a target="_blank" rel="noopener" href=";blobtype=pdf" title="fulltext PDF download" data-goatcounter-click="serp-fulltext" data-goatcounter-title="serp-fulltext"> <button class="ui simple right pointing dropdown compact black labeled icon button serp-button"> <i class="icon ia-icon"></i> Web Archive [PDF] <div class="menu fulltext-thumbnail"> <img src="" alt="fulltext thumbnail" loading="lazy"> </div> </button> </a> <a target="_blank" rel="external noopener noreferrer" href=""> <button class="ui left aligned compact blue labeled icon button serp-button"> <i class="unlock alternate icon" style="background-color: #fb971f;"></i> </button> </a> <a target="_blank" rel="external noopener" href="" title="pubmed link"> <button class="ui compact blue labeled icon button serp-button"> <i class="file alternate outline icon"></i> </button> </a>