在医院的队列中,AT (N) 分类的实际应用和疾病修饰治疗的资格在医院的队列中
Elisa Canu1, Giulia Rugarli1,2,3, Federico Coraglia1,3
1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
在临床环境中,AT(N分类系统有效地对阿尔茨海默病 (AD) 患者进行分类. 然而,只有很小一部分粉样蛋白阳性病例符合当前疾病修饰治疗的资格.
科学领域:
- 神经学 神经学
- 生物标志物研究 生物标志物研究
- 神经退行性疾病 神经退行性疾病
背景情况:
- 在AT(N) 分类系统使用生物标志物 (粉样β,,神经退行) 的配置文件来分层患者.
- 了解这些概况对于诊断和管理阿尔茨海默病 (AD) 和相关疾病至关重要.
- 在不同的临床群体中,AT ((N) 的现实应用对于完善诊断和治疗策略至关重要.
研究的目的:
- 将AT(N) 分类应用于患有认知衰退或痴呆症的医院患者队列.
- 调查这些患者是否有资格接受阿杜卡努马布和莱卡内马布等疾病修饰性治疗.
- 在临床背景下增强对阿尔茨海默病和相关疾病的多维方面的理解.
主要方法:
- 记忆中心队列中的429名患者的回顾性评估.
- 使用了临床/神经心理评估,腰部穿刺和脑部成像 (FDG-PET,MRI,CT).
- 使用AT(N) 分类分层的患者,并计算了对抗粉样蛋白治疗的资格.
主要成果:
- 最常见的是A+T+N+组 (38%),其次是A+T-N+ (21%) 和A-T-N+ (21%).
- A+T+N+组在多个领域表现出更严重的认知缺陷.
- 尽管61%的病例是粉样蛋白阳性 (A+),但只有17%的人有资格接受粉样蛋白向治疗.
结论:
- AT(N) 分类是用于现实世界临床环境的实用工具,有助于管理和治疗策略.
- 低认知表现和特定的FDG-PET低代谢模式表明A+T+或A-T+个人资料.
- 粉样蛋白病理的阿兹海默氏症患者的比例与那些符合当前疾病修饰疗法的患者之间存在很大的差距,这突显了早期检测的必要性.
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