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Challenges associated with biomarker-based classification systems for Alzheimer's disease
Ignacio Illán-Gala1,2, Jordi Pegueroles1,2, Victor Montal1,2
1Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Alzheimer'S & Dementia (Amsterdam, Netherlands)
|September 4, 2018
Summary
The A/T/N classification system for Alzheimer's disease lacks consistency, with significant discordance across patient groups. Amyloid biomarkers showed agreement, but neurodegeneration biomarkers did not, limiting clinical utility.
Area of Science:
- Neurology
- Biomarker Research
- Alzheimer's Disease Diagnostics
Background:
- The A/T/N (Amyloid, Tau, Neurodegeneration) classification system is crucial for diagnosing Alzheimer's disease.
- Evaluating the consistency of this system is essential for its reliable clinical application.
Purpose of the Study:
- To assess the consistency of the A/T/N classification system in differentiating Alzheimer's disease stages.
- To evaluate the agreement and correlation between amyloid and neurodegeneration biomarkers.
Main Methods:
- Utilized data from the Alzheimer's Disease Neuroimaging Initiative, including healthy controls, mild cognitive impairment, and dementia patients.
- Assessed classification consistency using various biomarker combinations.
- Analyzed agreement and correlation between amyloid and neurodegeneration biomarkers.
Main Results:
- Subject classification discordance varied significantly across all groups, ranging from 12.2% to 44.5%.
- Amyloid biomarkers demonstrated good agreement, unlike neurodegeneration biomarkers, which showed poor correlation.
- Biomarker relationships were dependent on the stage of Alzheimer's disease.
Conclusions:
- The current A/T/N classification system exhibits insufficient consistency for routine clinical use.
- Further refinement of the A/T/N system is necessary to improve diagnostic reliability in Alzheimer's disease.