Evidence map›Paper›PMID 29651720›Full record

Observational studyNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2018

Biomarkers study in atypical dementia: proof of a diagnostic work-up.

Gemma Lombardi, Cristina Polito, Valentina Berti, Camilla Ferrari, Giulia Lucidi, Silvia Bagnoli, Irene Piaceri, Benedetta Nacmias, Alberto Pupi, Sandro Sorbi

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Gemma LombardiDepartment of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, viale Pieraccini 6, 50139, Florence, Italy. glombardi@unifi.it.ORCID http://orcid.org/0000-0003-2699-0359
Cristina PolitoDepartment of Biomedical, Experimental and Clinical Sciences "Mario Serio," Nuclear Medicine Unit, University of Florence, viale Morgagni 50, 50134, Florence, Italy.
Valentina BertiDepartment of Biomedical, Experimental and Clinical Sciences "Mario Serio," Nuclear Medicine Unit, University of Florence, viale Morgagni 50, 50134, Florence, Italy.
Camilla FerrariDepartment of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, viale Pieraccini 6, 50139, Florence, Italy.
Giulia LucidiDepartment of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, viale Pieraccini 6, 50139, Florence, Italy.
Silvia BagnoliDepartment of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, viale Pieraccini 6, 50139, Florence, Italy.
Irene PiaceriDepartment of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, viale Pieraccini 6, 50139, Florence, Italy.
Benedetta NacmiasDepartment of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, viale Pieraccini 6, 50139, Florence, Italy.
Alberto PupiDepartment of Biomedical, Experimental and Clinical Sciences "Mario Serio," Nuclear Medicine Unit, University of Florence, viale Morgagni 50, 50134, Florence, Italy.
Sandro SorbiDepartment of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, viale Pieraccini 6, 50139, Florence, Italy.
University of Florence · ITDon Carlo Gnocchi Foundation · IT

Funding

Fondazione CRF Grant 2015.0722
6 · The paper itself

Abstract

backgroundAn early differentiation between Alzheimer's Disease (AD) and other dementias is crucial for an adequate patients' management, albeit it may result difficult for the occurrence of "atypical presentations." Current diagnostic criteria recognize the importance of biomarkers for AD diagnosis, but still an optimal diagnostic work-up isn't available.

objectiveEvaluate the utility and reproducibility of biomarkers and propose an "optimal" diagnostic work-up in atypical dementia.

methods(1) a retrospective selection of "atypical dementia cases"; (2) a repetition of diagnostic assessment by two neurologists following two different diagnostic work-ups, each consisting of multiple steps; (3) a comparison between diagnostic accuracy and confidence reached at each step by both neurologists and evaluation of the inter-rater agreement.

resultsIn AD, regardless of the undertaken diagnostic work-up, a significant gain in accuracy was reached by both neurologists after the second step, whereas in frontotemporal dementia (FTD), adding subsequent steps was not always sufficient to increase significantly the baseline accuracy. A relevant increment in diagnostic confidence was detectable after studying pathophysiological markers in AD, and after assessing brain metabolism in FTD. The inter-rater agreement was higher at the second step for the AD group when the pathophysiological markers were available and for the FTD group when the results of FDG-PET were accessible.

conclusionsIn atypical cases of dementia, biomarkers significantly raise diagnostic accuracy, confidence, and agreement. This study introduces a proof of diagnostic work-up that combines imaging and CSF biomarkers and suggests distinct ways to proceed on the basis of a greater diagnostic likelihood.

Indexed as

AgedAmyloid beta-PeptidesBiomarkersBrainDementiaDiagnosis, DifferentialFemaleFluorodeoxyglucose F18HumansMaleMiddle AgedNeuropsychological TestsObserver VariationPeptide FragmentsPhosphorylationPositron-Emission TomographyAmyloid beta-Peptidesamyloid beta-protein (1-42)BiomarkersFluorodeoxyglucose F18MAPT protein, humanPeptide FragmentsRadiopharmaceuticalstau ProteinsAlzheimer’s DiseaseBiomarkerCerebrospinal fluidDiagnostic work-upFrontotemporal DementiaPET imaging

Identifiers

PMID29651720
OpenAlexW2796987150

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.