Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria |
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| Authors: | Dubois Bruno Feldman Howard H Jacova Claudia Dekosky Steven T Barberger-Gateau Pascale Cummings Jeffrey Delacourte André Galasko Douglas Gauthier Serge Jicha Gregory Meguro Kenichi O'brien John Pasquier Florence Robert Philippe Rossor Martin Salloway Steven Stern Yaakov Visser Pieter J Scheltens Philip |
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| Affiliation: | 1. INSERM U610, Hôpital de la Salpêtrière, Paris, France, and Université Pierre et Marie Curie–Paris6, Paris, France;2. Division of Neurology, University of British Columbia and Vancouver Coastal Health, Vancouver BC, Canada;3. Department of Neurology, University of Pittsburgh, Pittsburgh, USA;4. INSERM U593, Université Victor Segalen Bordeaux 2, France;5. University of California at Los Angeles Alzheimer''s Disease Center, USA;6. CHU de Lille, Centre INSERM JPA, Bâtiment Gérard Biserte, Lille, France;7. Department of Neurosciences, University of California, San Diego, California, USA;8. McGill Center for Studies in Aging, Douglas Hospital, Montreal, Quebec, Canada;9. Department of Neurology; University of Kentucky Medical Center; Sanders-Brown Center on Aging; Lexington, USA;10. Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan;11. Wolfson Research Centre, Institute for Ageing and Health, Newcastle General Hospital, Newcastle upon Tyne, UK;12. Neurology Department, Memory Clinic, Lille University Hospital, France;13. Centre Mémoire de Ressources et de Recherche, Pavillon M, Hôpital Pasteur, Nice, France;14. Dementia Research Group, Department of Clinical Neurology, Institute of Neurology, London, UK;15. Department of Clinical Neurosciences, Brown University, Providence, RI, USA;p. Cognitive Neuroscience Division of the Taub Institute, Presbyterian Hospital, New York, USA;q. Department of Neurology and Alzheimer Center, VU University Medical Center, Netherlands;1. Département de neurologie, ICM, UMR 975, UPCM hôpital de la Salpêtrière, institut de la mémoire et de la maladie d’Alzheimer (IM2A), 47, boulevard de l’Hôpital, 75013 Paris, France;2. Service de neurologie, université Paris Descartes, Sorbonne Paris Cité, Inserm UMR S894, hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France;3. Département de psychiatrie, université de Frankfort, 10, Heinrich-Hoffmann-Str, 60528 Frankfurt, Germany;1. Institute of Memory and Alzheimer''s Disease (IM2A) and Brain and Spine Institute (ICM) UMR S 1127 Frontlab, Department of Neurology, AP_HP, Pitié-Salpêtrière University Hospital, Sorbonne Universities, Pierre et Marie Curie University, Paris 06, Paris, France;2. AXA Research Fund & UPMC Chair, Paris, France;3. University of British Columbia, Canada;4. Department of Neurology and Alzheimer Center, VU University Medical Center and Neuroscience Campus, Amsterdam, The Netherlands;5. University of Southern California San Diego, CA, USA;6. UMR1027, INSERM, Université Toulouse III, Toulouse University Hospital, France;7. IHU-A-ICM—Institut des Neurosciences translationnelles de Paris, Paris, France;8. INSERM U1146—CNRS UMR 7371—UPMC UM CR2, Site Pitié-Salpêtrière, Paris, France;9. Lübeck Interdisciplinary Platform for Genome Analytics (LIGA), Institutes of Neurogenetics and Integrative and Experimental Genomics, University of Lübeck, Lübeck, Germany;10. School of Public Health, Faculty of Medicine, Imperial College London, London, UK;11. Clinical Neurochemistry Lab, Department of Neuroscience and Physiology, University of Gothenburg, Mölndal Hospital, Sahlgrenska University Hospital, Mölndal, Sweden;12. Federal Institute for Drugs and Medical Devices, Bonn, Germany;13. Laboratory of Alzheimer''s Neuroimaging and Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy;14. Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK;15. INSERM U 1219, Université de Bordeaux, France;p. University Pierre et Marie Curie, Assistance Publique des Hôpitaux de Paris, Alzheimer-Prion Team Institut du Cerveau et de la Moelle (ICM), Paris, France;q. University Hospitals and University of Geneva, Geneva, Switzerland;r. IRCCS Fatebenefratelli, Brescia, Italy;s. McGill Center for Studies in Aging, Douglas Mental Health Research Institute, Montreal, Canada;t. Fondation pour la Recherche sur Alzheimer, Hôpital Pitié-Salpêtrière, Paris, France;u. Department of Clinical Neurophysiology/MEG Center, VU University Medical Center, Amsterdam;v. Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d''Imagerie Biomédicale, Paris, France;w. AP-HP, Hôpital Pitié-Salpêtrière, Département de Médecine Nucléaire, Paris, France;x. Department of Neurology, Washington University, Hope Center for Neurological Disorders, St. Louis, MO, USA;y. Department of Neurology, Washington University, Knight Alzheimer''s Disease Research Center, St. Louis, MO, USA;z. Center for Alzheimer Research, Karolinska Institutet, Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden;11. Institute of Clinical Medicine/ Neurology, University of Eastern Finland, Kuopio, Finland;12. Alzheimer''s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d''Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain;13. Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain;14. Center for Alzheimer''s & Neurodegenerative Disease Research, University of North Texas Health Science Center, TX, USA;15. Memory & Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA;16. Department of Molecular Imaging, Austin Health, University of Melbourne, Australia;17. Memory and Aging Program, Butler Hospital, Alpert Medical School of Brown University, USA;18. Department of Neurology, Alpert Medical School of Brown University, USA;19. Department of Psychiatry, Alpert Medical School of Brown University, USA;110. Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA;111. Harvard Medical School, Memory Disorders Unit, Center for Alzheimer Research and Treatment, Brigham and Women''s Hospital, Boston, USA;112. Harvard Medical School, Memory Disorders Unit, Center for Alzheimer Research and Treatment, Massachusetts General Hospital, Boston, USA;113. The Alzheimer''s Association Division of Medical & Scientific Relations, Chicago, USA;114. Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA;115. Department of Radiology, Mayo Clinic, Rochester MN, USA;1. Division of Medical & Scientific Relations, Alzheimer''s Association, Chicago, IL, USA;2. Lilly Research Labs, Eli Lilly & Co., Indianapolis, IN, USA;3. Medical Diagnostics, General Electric, London, United Kingdom;4. Dementia and Geriatric Psychiatry, Bracket, Wayne, PA, USA;5. Global Clinical Research, Neuroscience, Bristol-Myers Squibb, Wallingford, CT, USA;6. PAD2020, Rockville, MD, USA;7. Philadelphia, PA, USA;8. Pfizer, New York, NY, USA;9. Department of Neurology, Mayo Clinic, Rochester, MN, USA;1. Department of Neurology, Mayo Clinic, Rochester, MN, USA;2. Department of Radiology, Mayo Clinic, Rochester, MN, USA;3. Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK;4. Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA;5. Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Center, Amsterdam, Netherlands;6. Alzheimer''s Association, Chicago, IL, USA;7. Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;8. Department of Neurology, Radiology, and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA;9. Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA;1. Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden;2. Department of Biomedical Sciences, University of Antwerp, Belgium;3. Department of Radiation Physics, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;4. Alzforum, Cambridge, MA, USA;5. Unit for Health Metrics, Department of Medicine, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;6. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;7. Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK |
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| Abstract: | ![]()
The NINCDS-ADRDA and the DSM-IV-TR criteria for Alzheimer's disease (AD) are the prevailing diagnostic standards in research; however, they have now fallen behind the unprecedented growth of scientific knowledge. Distinctive and reliable biomarkers of AD are now available through structural MRI, molecular neuroimaging with PET, and cerebrospinal fluid analyses. This progress provides the impetus for our proposal of revised diagnostic criteria for AD. Our framework was developed to capture both the earliest stages, before full-blown dementia, as well as the full spectrum of the illness. These new criteria are centred on a clinical core of early and significant episodic memory impairment. They stipulate that there must also be at least one or more abnormal biomarkers among structural neuroimaging with MRI, molecular neuroimaging with PET, and cerebrospinal fluid analysis of amyloid beta or tau proteins. The timeliness of these criteria is highlighted by the many drugs in development that are directed at changing pathogenesis, particularly at the production and clearance of amyloid beta as well as at the hyperphosphorylation state of tau. Validation studies in existing and prospective cohorts are needed to advance these criteria and optimise their sensitivity, specificity, and accuracy. |
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