您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报(医学版) ›› 2017, Vol. 55 ›› Issue (10): 14-20.doi: 10.6040/j.issn.1671-7554.0.2017.320

• 阿尔茨海默病防治专题 • 上一篇    下一篇

阿尔茨海默病诊断标准:从临床诊断到病理生理诊断

唐毅   

  1. 首都医科大学宣武医院神经内科, 北京 100053
  • 收稿日期:2017-04-12 出版日期:2017-10-10 发布日期:2017-10-10
  • 通讯作者: 唐毅. E-mail:tangyixw@163.com E-mail:tangyixw@163.com
  • 基金资助:
    国家自然科学基金(81671040);北京市优秀人才青年拔尖个人项目(2014000021223ZK31);北京市科学技术委员会资助项目(Z151100004015078)

Evolution of diagnostic criteria for Alzheimers disease: from clinical diagnosis to pathophysiological diagnosis

TANG Yi   

  1. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2017-04-12 Online:2017-10-10 Published:2017-10-10

摘要: 痴呆已经成为老年人群致死和致残的主要疾病之一,而阿尔茨海默病(AD)是痴呆的首要病因。AD的第一个诊断标准是1984年由美国神经语言障碍与卒中研究所和阿尔茨海默病与相关疾病协会工作组联合制订的。此后,随着对AD病理生理机制理解的逐渐深入和临床研究的需要,先后推出了两套AD的诊断标准,包括国际工作组发表于2007年、更新于2014年的IWG-1诊断标准,以及美国国立老化研究院和阿尔茨海默病协会于2011年制定的NIA-AA诊断标准。深入认识AD诊断标准的演变过程和不同诊断标准间的异同,对于理解AD的病理生理机制,更好地开展临床诊疗和科研工作有着重要意义。

关键词: 阿尔茨海默病, 诊断标准, 生物标记物, AD临床前阶段

Abstract: Alzheimers disease(AD)is the leading cause of dementia and the most prevalent neurodegenerative disease in the elderly. The first diagnostic criteria was developed by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimers Disease and Related Disorders Association Work Group in 1984. With the further understanding of pathophysiological mechanism underlying AD, two new sets of research criteria for Alzheimers 山 东 大 学 学 报 (医 学 版)55卷10期 -唐毅.阿尔茨海默病诊断标准:从临床诊断到病理生理诊断 \=-disease were proposed: those published by an International Working Group in 2007, which was updated in 2014, and the recommendations published by the National Institute on Aging and the Alzheimers Association(NIA-AA)in 2011. A comparison of the criteria is needed for clinical practice and research purpose.

Key words: Alzheimers disease, Diagnostic criteria, Biomarker, Preclinical AD

中图分类号: 

  • R741.04
[1] McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimers disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimers Disease[J]. Neurology, 1984, 34(7): 939-944.
[2] Morris JC, Blennow K, Froelich L, et al. Harmonized diagnostic criteria for Alzheimers disease: recommendations[J]. J Intern Med, 2014, 275(3): 204-213.
[3] Dubois B, Feldman HH, Jacova C, et al. Research criteria for the diagnosis of Alzheimers disease: revising the NINCDS-ADRDA criteria[J]. Lancet Neuro, 2007, 6(8): 734-746.
[4] Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimers disease: the IWG-2 criteria[J]. Lancet Neuro, 2014, 13(6): 614-629.
[5] Sperling RA, Aisen PS, Beckett LA, et al. Toward defining the preclinical stages of Alzheimers disease: recommendations from the National Institute on Aging-Alzheimers Association workgroups on diagnostic guidelines for Alzheimers disease[J]. Alzheimers Dement, 2011, 7(3): 280-292.
[6] Albert MS, DeKosky ST, Dickson D, et al. The diagnosis of mild cognitive impairment due to Alzheimers disease: recommendations from the National Institute on Aging-Alzheimers Association workgroups on diagnostic guidelines for Alzheimers disease[J]. Alzheimers Dement, 2011, 7(3): 270-279.
[7] McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimers disease: recommendations from the National Institute on Aging-Alzheimers Association workgroups on diagnostic guidelines for Alzheimers disease[J]. Alzheimers Dement, 2011, 7(3): 263-269.
[8] Baldereschi M, Amato MP, Nencini P, et al. Cross-national interrater agreement on the clinical diagnostic criteria for dementia. WHO-PRA Age-Associated Dementia Working Group, WHO-Program for Research on Aging, Health of Elderly Program[J]. Neurology, 1994, 44(2): 239-242.
[9] Hjortso S, Butler B, Clemmesen L, et al. The use of case vignettes in studies of interrater reliability of psychiatric target syndromes and diagnoses. A comparison of ICD-8, ICD-10 and DSM-III[J]. Acta Psychiatr Scand, 1989, 80(6): 632-638.
[10] Graham JE, Rockwood K, Beattie BL, et al. Standardization of the diagnosis of dementia in the Canadian Study of Health and Aging[J]. Neuroepidemiology, 1996, 15(5): 246-256.
[11] Larson EB, McCurry SM, Graves AB, et al. Standardization of the clinical diagnosis of the dementia syndrome and its subtypes in a cross-national study: the Ni-Hon-Sea experience[J]. J Gerontol A Biol Sci Med Sci, 1998, 53(4): M313-319.
[12] Fratiglioni L, Grut M, Forsell Y, et al. Clinical diagnosis of Alzheimers disease and other dementias in a population survey. Agreement and causes of disagreement in applying Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, Criteria[J]. Arch Neurol, 1992, 49(9): 927-932.
[13] Lim A, Tsuang D, Kukull W, et al. Clinico-neuropathological correlation of Alzheimers disease in a community-based case series[J]. J Am Geriatr Soc, 1999, 47(5): 564-569.
[14] Varma AR, Snowden JS, Lloyd JJ, et al. Evaluation of the NINCDS-ADRDA criteria in the differentiation of Alzheimers disease and frontotemporal dementia[J]. J Neurol Neurosurg Psychiatry, 1999, 66(2): 184-188.
[15] Ranginwala NA, Hynan LS, Weiner MF, et al. Clinical criteria for the diagnosis of Alzheimer disease: still good after all these years[J]. Am J Geriatr Psychiatry, 2008, 16(5): 384-388.
[16] Morris JC. Early-stage and preclinical Alzheimer disease[J]. Alzheimer Dis Assoc Disord, 2005, 19(3): 163-165.
[17] Kazee AM, Eskin TA, Lapham LW, et al. Clinicopathologic correlates in Alzheimer disease: assessment of clinical and pathologic diagnostic criteria[J]. Alzheimer Dis Assoc Disord, 1993, 7(3): 152-164.
[18] Dubois B, Feldman HH, Jacova C, et al. Revising the definition of Alzheimers disease: a new lexicon[J]. Lancet Neuro, 2010, 9(11): 1118-1127.
[19] Aizenstein HJ, Nebes RD, Saxton JA, et al. Frequent amyloid deposition without significant cognitive impairment among the elderly[J]. Arch Neurol, 2008, 65(11): 1509-1517.
[20] Price JL, Morris JC. Tangles and plaques in nondemented aging and “preclinical” Alzheimers disease[J]. Ann Neurol, 1999, 45(3): 358-368.
[21] Bennett DA, Schneider JA, Arvanitakis Z, et al. Neuropathology of older persons without cognitive impairment from two community-based studies[J]. Neurology, 2006, 66(12): 1837-1844.
[22] Sperling RA, Aisen PS, Beckett LA, et al. Toward defining the preclinical stages of Alzheimers disease: recommendations from the National Institute on Aging-Alzheimers Association Workgroups on diagnostic guidelines for Alzheimers disease[J]. Alzheimers Dement, 2011, 7(3): 280-292.
[23] Slaets S, Le Bastard N, Theuns J, et al. Amyloid pathology influences abeta1-42 cerebrospinal fluid levels in dementia with lewy bodies[J]. J Alzheimers Dis, 2013, 35(1): 137-146.
[24] Perret-Liaudet A, Pelpel M, Tholance Y, et al. Risk of Alzheimers disease biological misdiagnosis linked to cerebrospinal collection tubes[J]. J Alzheimers Dis, 2012, 31(1): 13-20.
[25] Bian H, Van Swieten JC, Leight S, et al. CSF biomarkers in frontotemporal lobar degeneration with known pathology[J]. Neurology, 2008, 70(19 Pt 2): 1827-1835.
[26] Schoonenboom NS, Reesink FE, Verwey NA, et al. Cerebrospinal fluid markers for differential dementia diagnosis in a large memory clinic cohort[J]. Neurology, 2012, 78(1): 47-54.
[27] de Souza LC, Lamari F, Belliard S, et al. Cerebrospinal fluid biomarkers in the differential diagnosis of Alzheimers disease from other cortical dementias[J]. J Neurol Neurosurg Psychiatry, 2011, 82(3): 240-246.
[28] Brys M, Pirraglia E, Rich K, et al. Prediction and longitudinal study of CSF biomarkers in mild cognitive impairment[J]. Neurobiol Aging, 2009, 30(5): 682-690.
[29] de Jager CA, Honey TE, Birks J, et al. Retrospective evaluation of revised criteria for the diagnosis of Alzheimers disease using a cohort with post-mortem diagnosis[J]. Int J Geriatr Psychiatry, 2010, 25(10): 988-997.
[30] Harris JM, Thompson JC, Gall C, et al. Do NIA-AA criteria distinguish Alzheimers disease from frontotemporal dementia?[J]. Alzheimers Dement, 2015, 11(2): 207-215.
[31] Visser PJ, Vos S, van Rossum I, et al. Comparison of International Working Group criteria and National Institute on Aging-Alzheimers Association criteria for Alzheimers disease[J]. Alzheimers Dement, 2012, 8(6): 560-563.
[32] Winblad B, Palmer K, Kivipelto M, et al. Mild cognitive impairment - beyond controversies, towards a consensus: report of the International Working Group on mild cognitive impairment[J]. J Intern Med, 2004, 256(3): 240-246.
[33] 王晓妮, 唐毅, 韩璎.阿尔茨海默病诊断标准的演变[J].医学研究生学报, 2015, 28(2): 195-198. WANG Xiaoni, TANG Yi, HAN Ying. The evolution of criteria for the diagnosis of Alzheimers disease[J].J Med Postgra, 2015, 28(2): 195-198.
[1] 闫鹏 王蓉 杜怡峰 沈伦乾. 老年性痴呆患者尿中AD7c-NTP含量的研究[J]. 山东大学学报(医学版), 2209, 47(6): 106-.
[2] 李蒙蒙,王苗苗,刁雪琴,田克立,徐霞,任桂杰. 阿尔茨海默病细胞模型中lncRNA RP11-543N12.1对CDH13表达的调控作用[J]. 山东大学学报(医学版), 2017, 55(3): 12-18.
[3] 杜蘅,袁晓东. 阿尔茨海默病病因及发病机制研究进展[J]. 山东大学学报(医学版), 2017, 55(10): 21-27.
[4] 仇成轩, 杜怡峰. 重视阿尔茨海默病和老年痴呆症的人群干预研究[J]. 山东大学学报(医学版), 2017, 55(10): 1-6.
[5] 杜怡峰,井然. 阿尔茨海默病的诊断与治疗[J]. 山东大学学报(医学版), 2017, 55(10): 7-13.
[6] 李懋禹,唐诗,杜怡峰. TRB3在APP/PS1转基因小鼠脑内的表达及其意义[J]. 山东大学学报(医学版), 2016, 54(10): 1-5.
[7] 李梅, 孟庆慧, 蔡巧英, 徐雁, 范晓婷. 乙酰葛根素对Aβ25-35诱导BV-2小胶质细胞Caspase-3表达的影响[J]. 山东大学学报(医学版), 2015, 53(10): 32-36.
[8] 赵雪莲, 于君, 谢兆宏, 曹彦军, 刘震, 王晓, 徐琳琳, 杨慧, 郑晓磊, 沈阳, 毕建忠. 线粒体自噬在阿尔茨海默病细胞模型中的作用机制[J]. 山东大学学报(医学版), 2015, 53(10): 1-5.
[9] 葛树建, 林炜炜, 丛琳, 张涛, 韩晓娟, 张清华, 杜怡峰. 基于Web构建山东省阿尔茨海默病临床数据库[J]. 山东大学学报(医学版), 2015, 53(10): 42-45.
[10] 王金红, 李文涛, 于树田, 董丽. 多奈哌齐对阿尔茨海默病模型大鼠下丘脑-垂体-肾上腺轴的影响[J]. 山东大学学报(医学版), 2014, 52(7): 11-15.
[11] 钱冰,吕春娥,田晓康,高殿帅,刘志安. 钙调蛋白依赖性蛋白激酶Ⅱ在AD样大鼠海马的表达及其与细胞凋亡的关系[J]. 山东大学学报(医学版), 2014, 52(2): 44-47.
[12] 亓珅,韩晓娟,王璐,张清华,杜怡峰. 海风藤提取物对激活的小胶质细胞IL-1β和TNF-α表达的影响[J]. 山东大学学报(医学版), 2013, 51(5): 11-14.
[13] 武传龙1,许良银2,侯新国1,赵汝星1,陈丽1. 甲状腺功能与肥胖及代谢综合征的相关性分析[J]. 山东大学学报(医学版), 2013, 51(12): 88-91.
[14] 殷青青,刘雪平,董传芳,董雪丽,李艳菊, 罗鼎真,侯训尧. 糖基化终末产物对大鼠基底前脑胆碱能神经元的损伤作用[J]. 山东大学学报(医学版), 2012, 50(8): 20-.
[15] 陈敏,单培彦,刘爱芬,麻琳,于晓琳. 阿尔茨海默病患者血糖、胰岛素及胰岛素降解酶水平的研究[J]. 山东大学学报(医学版), 2012, 50(3): 75-.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!