Strategic roadmap for an early diagnosis of Alzheimer&#039;s disease based on biomarkers

Frisoni, Giovanni; Boccardi, Marina; Garibotto, Valentina; Giannakopoulos, Panteleimon; Albanese, Emiliano; Giacobini, Ezio; Gold, Gabriel; Hurst, Samia; Lövblad, Karl-Olof; Ratib, Osman

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Title		Strategic roadmap for an early diagnosis of Alzheimer's disease based on biomarkers
Authors		Frisoni, Giovanni Boccardi, Marina Garibotto, Valentina Giannakopoulos, Panteleimon Albanese, Emiliano Giacobini, Ezio Gold, Gabriel Hurst, Samia Lövblad, Karl-Olof Ratib, Osman show all authors [1 - 10]
Published in		The Lancet Neurology. 2017, vol. 16, no. 8, p. 661-676
Abstract		The diagnosis of Alzheimer's disease can be improved by the use of biological measures. Biomarkers of functional impairment, neuronal loss, and protein deposition that can be assessed by neuroimaging (ie, MRI and PET) or CSF analysis are increasingly being used to diagnose Alzheimer's disease in research studies and specialist clinical settings. However, the validation of the clinical usefulness of these biomarkers is incomplete, and that is hampering reimbursement for these tests by health insurance providers, their widespread clinical implementation, and improvements in quality of health care. We have developed a strategic five-phase roadmap to foster the clinical validation of biomarkers in Alzheimer's disease, adapted from the approach for cancer biomarkers. Sufficient evidence of analytical validity (phase 1 of a structured framework adapted from oncology) is available for all biomarkers, but their clinical validity (phases 2 and 3) and clinical utility (phases 4 and 5) are incomplete. To complete these phases, research priorities include the standardisation of the readout of these assays and thresholds for normality, the evaluation of their performance in detecting early disease, the development of diagnostic algorithms comprising combinations of biomarkers, and the development of clinical guidelines for the use of biomarkers in qualified memory clinics.
Keywords		Alzheimer Disease/diagnosis — Biomarkers — Early Diagnosis — Humans — Validation Studies as Topic
Identifiers		DOI: 10.1016/S1474-4422(17)30159-X PMID: 28721928
Full text		Article (Published version) (440 Kb) - Limited access to UNIGE
Structures		Faculté de médecine / Section de médecine clinique / Département de psychiatrie Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale
Research groups		Ischémie cérébrale et connectivité (801) Ethique biomédicale (783) Démence du sujet âgé, troubles cognitifs, la symptomatologie cognitive (577) Groupe Giannakopoulos Panteleimon (psychiatrie générale) (201) Laboratoire de neuroimagerie et de traceurs moléculaires innovants (984) Troubles de mémoire et maladie d'Alzeimer (935)
Citation (ISO format)		FRISONI, Giovanni et al. Strategic roadmap for an early diagnosis of Alzheimer's disease based on biomarkers. In: The Lancet Neurology, 2017, vol. 16, n° 8, p. 661-676. https://archive-ouverte.unige.ch/unige:99217