Breaking News
December 19, 2018 - Potential combination therapy against rare disease of the bone marrow could improve treatment
December 19, 2018 - UC San Diego Health offers new DRG stimulation device for phantom limb pain
December 19, 2018 - Study examines relationship between growth restriction and risk of childhood mortality
December 19, 2018 - New study provides insights on increased risk of suicide in young patients visiting ED
December 19, 2018 - AHA: Thyroid Problems Linked to Worsening Heart Failure
December 19, 2018 - World-first coeliac disease vaccine enters Phase 2 trials
December 19, 2018 - RNA sequencing offers novel insights into the microbiome
December 19, 2018 - A promising, effective vaccine for common respiratory disease
December 19, 2018 - Protein may slow progression of emphysema, study finds
December 19, 2018 - Studying atrial fibrillation — and exploring new frontiers in precision health
December 19, 2018 - A New Way To Get College Students Through A Psychiatric Crisis — And Back To School
December 19, 2018 - Optum, UnitedHealthcare take action to help people affected by North Carolina winter storms
December 18, 2018 - Weight change in middle-aged, elderly Chinese Singaporeans related to increased risk of death
December 18, 2018 - Immune cells sacrifice themselves to protect us from invading bacteria
December 18, 2018 - Watching brain cells fire, with a twist of gravitational waves
December 18, 2018 - 2018 in Review
December 18, 2018 - Getting the Most Out of the CLARITY Technique
December 18, 2018 - NVF shoes provide a viable option for track and road racing
December 18, 2018 - CRISPR may restore effectiveness of chemotherapies used to treat lung cancer
December 18, 2018 - New app accurately measures and charts progression of skin wounds
December 18, 2018 - Persistent Discrimination ID’d Among Physician Mothers
December 18, 2018 - Cellphone technology developed to detect HIV
December 18, 2018 - A Stanford doctor hits the field with the 49ers — as their airway management physician
December 18, 2018 - The Rise of Anxiety Baking
December 18, 2018 - Just one night of sleep deprivation increases the urge to eat
December 18, 2018 - Study reveals mechanism behind failed remyelination in MS
December 18, 2018 - New genetic testing method increases the precision of biomarker analysis
December 18, 2018 - Simple technique to effectively treat underdiagnosed cause of debilitating chest pain
December 18, 2018 - Barbershop-based medical intervention can successfully lower blood pressure, new data shows
December 18, 2018 - Food labels have caused changes in consumers’ intake and industry’s use of key additives
December 18, 2018 - Sickest children could benefit from split liver transplants
December 18, 2018 - Scientists create patient-specific model to identify most effective treatment for appendix cancer
December 18, 2018 - ‘Little Foot’ endocast reveals a small brain combining ape-like and human-like features
December 18, 2018 - New therapy for childhood blindness shows ‘very promising’ results
December 18, 2018 - Researchers discover promising new compound against Buruli ulcer
December 18, 2018 - Study finds significant use of traditional, complementary and alternative medicines in Sub-Saharan Africa
December 18, 2018 - California Farm Implicated in Outbreak of E. coli Tied to Romaine Lettuce
December 18, 2018 - Mobile health has power to transform HIV/AIDS nursing
December 18, 2018 - Celiac Vaccine in Clinical Trials at Columbia
December 18, 2018 - Research into mental health first aid prompts practical guidance and resources for workplace
December 18, 2018 - Researcher conducts study to investigate peripheral blood markers of Alzheimer’s disease
December 18, 2018 - Researchers identify link between mucus in the small airways and pulmonary fibrosis
December 18, 2018 - EU Commission’s Health Policy Platform to host EKHA program on transplantation
December 18, 2018 - Survivors of childhood Hodgkin lymphoma have high risk of developing solid tumors
December 18, 2018 - Small changes to cafeteria design can get kids to eat healthier, new assessment tool finds
December 18, 2018 - From Machines to Cyclic Compounds
December 18, 2018 - New study reveals best assessment tools to establish delirium severity
December 18, 2018 - Rice University scientists develop synthetic protein switches to control electron flow
December 18, 2018 - Home-based pulmonary function monitoring for teens with Duchenne muscular dystrophy
December 18, 2018 - Researchers identify potential target for new breast cancer treatments
December 18, 2018 - National Biofilms Innovation Centre award grant to Neem Biotech for novel anti-biofilm drug development
December 18, 2018 - Artificial intelligence and the future of medicine
December 18, 2018 - Montana State doctoral student receives grant for her work to improve neuroscience tool
December 18, 2018 - Early postpartum initiation of opioids associated with persistent use
December 18, 2018 - Russian scientists identify molecular ‘switch’ that could be target for treatment of allergic asthma
December 18, 2018 - Surgeons make more mistakes in the operating room during stressful moments, shows study
December 18, 2018 - Immune cells explode themselves to inform about the danger of invading bacteria
December 18, 2018 - Malnutrition in children with Crohn’s disease linked with increased risk of surgical complications
December 18, 2018 - FDA Approves Motegrity (prucalopride) for Adults with Chronic Idiopathic Constipation (CIC)
December 18, 2018 - The long and short of CDK12
December 18, 2018 - Hologic’s Cynosure division introduces TempSure Surgical RF technology in North America
December 18, 2018 - CMR Surgical partners with Nicholson Center to launch U.S.-based training program for Versius
December 18, 2018 - Findings reinforce guidelines for cautious use of antipsychotics in younger populations
December 18, 2018 - Study finds new strains of hepatitis C virus in sub-Saharan Africa
December 18, 2018 - New battery-free, implantable device aids weight loss
December 18, 2018 - Parental alcohol use disorder associated with offspring marital outcomes
December 18, 2018 - Novel Breast Imaging Technique Might Cut Unnecessary Biopsies
December 18, 2018 - What can a snowflake teach us about how cancer spreads in the body?
December 18, 2018 - Management of nausea and vomiting in pregnancy costs the NHS more than previously thought
December 18, 2018 - Green leafy vegetables may reduce risk of developing liver steatosis
December 18, 2018 - Veganism linked to nutrient deficiencies and malnutrition if not planned correctly
December 18, 2018 - Coming Soon: A Tiny Robot You Swallow to Help You Stay Healthy
December 18, 2018 - Modified malaria drug proven effective at inhibiting Ebola
December 18, 2018 - Study finds epigenetic differences in the brains of individuals with schizophrenia
December 18, 2018 - Fitness instructors’ motivational comments influence women’s body satisfaction
December 18, 2018 - Study focuses on modification of lipid nanoparticles for successful brain cell targeting
December 18, 2018 - New gut bacteria may be effective against obesity, metabolic and mental disorders
December 18, 2018 - New two-in-one powder aerosol to upgrade fight against deadly superbugs in lungs
December 18, 2018 - Biofilms feed with swirling flows
December 17, 2018 - Study identifies specific neurological changes related to traumatic brain injury
New AUC published for lumbar puncture and spinal fluid analysis in Alzheimer’s diagnosis

New AUC published for lumbar puncture and spinal fluid analysis in Alzheimer’s diagnosis

image_pdfDownload PDFimage_print

In preparation for more tools that detect and measure the biology associated with Alzheimer’s and other dementias earlier and with more accuracy, an Alzheimer’s Association-led Workgroup has published appropriate use criteria (AUC) for lumbar puncture (spinal tap) and spinal fluid analysis in the diagnosis of Alzheimer’s disease.

The AUC is available online by Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association as an article in press, corrected proof.

“Early and accurate diagnosis of Alzheimer’s disease is critical as therapies that have the potential to stop or slow the progression of the disease become available,” said Maria C. Carrillo, Ph.D., Chief Science Officer at the Alzheimer’s Association. “These criteria will arm medical professionals with necessary guidance when the use of lumbar puncture is an appropriate part of the process to diagnose Alzheimer’s disease and other dementias, thereby giving people with dementia and their families the possibility of a head start in preparing for the course of their disease.”

Alzheimer’s disease is commonly diagnosed by a thorough examination of physical health, medical history and assessment of memory, thinking and reasoning. Lumbar puncture, while not currently in routine clinical practice in the U.S., is anticipated to be a safe and cost-effective way to retrieve cerebrospinal fluid (CSF) to test for biological markers of Alzheimer’s disease, potentially delivering valuable diagnostic information to clinicians and their patients earlier in the course of the disease.

The Workgroup’s efforts complement the 2013 AUC for brain amyloid PET scans developed by the Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the Alzheimer’s Association.

The lumbar puncture AUC criteria recommend clinicians consider the following patient populations as appropriate and inappropriate:

Appropriate uses of lumbar puncture:

  • A patient has subjective cognitive decline (SCD) and is considered to be at an increased risk for Alzheimer’s disease based on indicators that include a persistent decline in memory, younger onset age (>60), onset in the last 5 years and others. The decision to perform CSF biomarker testing in this case should be individualized and most strongly supported when the individual, family and clinician all are concerned about the patient’s cognitive decline.
  • A patient has mild cognitive impairment (MCI) that is persistent, progressive and unexplained. MCI includes mild deficits on cognitive testing but no change in functional abilities.
  • A patient has symptoms that suggest possible Alzheimer’s disease, meaning the dementia could be due to another cause.
  • A patient has MCI or dementia with onset at an early age (<65).
  • A patient meets core clinical criteria for probable Alzheimer’s disease with typical age of onset.
  • A patient’s dominant symptom is an unexplained change in behavior, such as delusions and delirium, and an Alzheimer’s disease diagnosis is being considered.

Inappropriate uses of lumbar puncture:

  • A patient is cognitively unimpaired, is within the normal range of functioning for their age and lacks significant risk factors for Alzheimer’s disease.
  • A patient is cognitively unimpaired but is considered to be at risk for Alzheimer’s disease based on their family history.
  • A patient has SCD and has been evaluated and found by a clinician not to be at high risk for Alzheimer’s disease based on indications such as no family history or limited concern from an informant like a partner or family member.
  • A patient has symptoms of rapid eye movement (REM) sleep behavior disorder, which is a strong predictor of disorders such as Parkinson’s disease and Lewy body dementia.
  • A patient already has been diagnosed with Alzheimer’s and the test’s use would be to determine the stage of their disease or its severity.
  • A patient is an apolipoprotein E-e4 (ApoE-e4) carrier who has no cognitive impairment. ApoE-e4 is a genetic mutation strongly associated with risk for late-onset Alzheimer’s.
  • The test is being used in lieu of genotyping for individuals who are suspected to carry a rare genetic mutation that causes an early-onset form of Alzheimer’s disease.

The AUC includes suggestions from the workgroup on implementing the criteria in clinical practice. They recommend that CSF biomarker testing be done by dementia experts who can determine the appropriateness of the test, educate the patient and family about the benefits and risks, ensure the procedure follows established guidelines, and integrate the results into the patient’s treatment plan.

Posted in: Medical Condition News

Tags: Alzheimer’s Disease, Apolipoprotein, Biomarker, Brain, Delirium, Dementia, Eye, Genetic, Genotyping, Imaging, Molecular Imaging, Mutation, Nuclear Medicine, OCT, Parkinson’s Disease, pH, Research, Sleep

Tagged with:

About author

Related Articles