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Prevalencia de la positividad del PET amiloide en los síndromes de demencia: un metanálisis
Rik Ossenkoppele1, Willemijn J Jansen2, Gil D Rabinovici3
1Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands 2Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands 3Memory and Aging Center, University of Californ.
JAMA
|May 20, 2015
Resumen
La imagen PET de amiloide-β revela que la prevalencia de placas varía según el tipo de demencia, la edad y el estado APOE ε4. Esto pone de relieve su potencial para el diagnóstico diferencial en los síndromes de demencia, especialmente para la enfermedad de Alzheimer (EA) en personas mayores que no son portadoras.
Área de la Ciencia:
- Neurología Neurología.
- Radiología Radiología.
- Genética La genética.
Sus antecedentes:
- La tomografía por emisión de positrones de amiloide-β (PET) detecta las placas fibrilares, una característica de la enfermedad de Alzheimer (EA).
- El valor diagnóstico del PET amiloide es limitado ya que las placas también aparecen en demencias no asociadas a la EA.
- El metanálisis de los datos de los participantes individuales es crucial para comprender la prevalencia de PET amiloide en diversos tipos de demencia.
Objetivo del estudio:
- Para estimar la prevalencia de positividad amiloide utilizando PET a través de varios síndromes de demencia.
- Para investigar la influencia de la edad y el estado de la apolipoproteína E (APOE) ε4 en la positividad del PET amiloide.
- Evaluar la utilidad del PET amiloide en la diferenciación de los diagnósticos de demencia.
Principales métodos:
- Metaanálisis de los datos de los participantes individuales de los estudios de PET amiloide (2004-2015).
- La inclusión de datos de 1359 participantes con AD diagnosticado clínicamente y 538 con demencia sin AD.
- Ecuaciones de estimación generalizadas utilizadas para modelar la prevalencia basada en el diagnóstico, la edad y el estado APOE ε4.
Principales resultados:
- La probabilidad de positividad de amiloide se correlacionó con la edad y el estado APOE ε4 en demencia AD y no AD.
- En la demencia de la EA, la positividad disminuyó con la edad, particularmente en los no portadores de APOE ε4.
- En las demencias no asociadas a la enfermedad de Alzheimer, la positividad amiloide generalmente aumentaba con la edad y la portadora de APOE ε4.
Conclusiones:
- El diagnóstico de demencia, la edad y el genotipo APOE influyen significativamente en la positividad del PET amiloide.
- El PET amiloide muestra potencial para el diagnóstico diferencial en la demencia de inicio temprano.
- Los hallazgos apoyan el uso de PET amiloide para ayudar al diagnóstico de la EA en no portadores de APOE ε4 más viejos.
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