Evaluating combinations of diagnostic tests to discriminate different dementia types

Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring - Tập 10 - Trang 509-518 - 2018
Marie Bruun1, Hanneke F.M. Rhodius-Meester2, Juha Koikkalainen3, Marta Baroni4, Le Gjerum1, Afina W. Lemstra2, Frederik Barkhof5,6, Anne M. Remes7,8, Timo Urhemaa9, Antti Tolonen9, Daniel Rueckert10, Mark van Gils9, Kristian S. Frederiksen1, Gunhild Waldemar1, Philip Scheltens2, Patrizia Mecocci4, Hilkka Soininen11, Jyrki Lötjönen3, Steen G. Hasselbalch1, Wiesje M. van der Flier2,12
1Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
2Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
3Combinostics Ltd., Tampere, Finland
4Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
5Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam Neuroscience, Amsterdam, the Netherlands
6UCL Institutes of Neurology and Healthcare Engineering, London, United Kingdom
7Medical Research Center, Oulu University Hospital, Oulu, Finland
8Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland
9VTT Technical Research Center of Finland Ltd, Tampere, Finland
10Department of Computing, Imperial College London, United Kingdom
11Institute of Clinical Medicine-Neurology, University of Eastern Finland, Kuopio, Finland
12Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, the Netherlands

Tóm tắt

AbstractIntroductionWe studied, using a data‐driven approach, how different combinations of diagnostic tests contribute to the differential diagnosis of dementia.MethodsIn this multicenter study, we included 356 patients with Alzheimer's disease, 87 frontotemporal dementia, 61 dementia with Lewy bodies, 38 vascular dementia, and 302 controls. We used a classifier to assess accuracy for individual performance and combinations of cognitive tests, cerebrospinal fluid biomarkers, and automated magnetic resonance imaging features for pairwise differentiation between dementia types.ResultsCognitive tests had good performance in separating any type of dementia from controls. Cerebrospinal fluid optimally contributed to identifying Alzheimer's disease, whereas magnetic resonance imaging features aided in separating vascular dementia, dementia with Lewy bodies, and frontotemporal dementia. Combining diagnostic tests increased the accuracy, with balanced accuracies ranging from 78% to 97%.DiscussionDifferent diagnostic tests have their distinct roles in differential diagnostics of dementias. Our results indicate that combining different diagnostic tests may increase the accuracy further.

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Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring

Tập 10

509-518

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