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Bruun, M., Rhodius-Meester, H., Koikkalainen, J., Baroni, M., Gjerum, L., Lemstra, A., Barkhof, F., Remes, A., Urhemaa, T., Tolonen, A., Rueckert, D., van Gils, M., Frederiksen, K., Waldemar, G., Scheltens, P., Mecocci, P., Soininen, H., Lötjönen, J., Hasselbalch, S., van der Flier, W. (2018) Evaluating combinations of diagnostic tests to discriminate different dementia types. Alzheimer’s & Dementia : Diagnosis, Assessment & Disease Monitoring, 10, 509-518. doi:10.1016/j.dadm.2018.07.003

Evaluating combinations of diagnostic tests to discriminate different dementia types

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Author: Bruun, Marie1; Rhodius-Meester, Hanneke F. M.2; Koikkalainen, Juha3;
Organizations: 1Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen
2Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience
3Combinostics Ltd.
4Institute of Gerontology and Geriatrics, University of Perugia
5Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam Neuroscience
6UCL Institutes of Neurology and Healthcare Engineering
7Medical Research Center, Oulu University Hospital
8Unit of Clinical Neuroscience, Neurology, University of Oulu
9VTT Technical Research Center of Finland Ltd
10Department of Computing, Imperial College, London
11Institute of Clinical Medicine, Neurology, University of Eastern Finland
12Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Neuroscience
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2018110147053
Language: English
Published: Elsevier, 2018
Publish Date: 2018-11-01
Description:

Abstract

Introduction: We studied, using a data-driven approach, how different combinations of diagnostic tests contribute to the differential diagnosis of dementia.

Methods: In this multicenter study, we included 356 patients with Alzheimer’s disease, 87 frontotemporal dementia, 61 dementia with Lewy bodies, 38 vascular dementia, and 302 controls. We used a classifier to assess accuracy for individual performance and combinations of cognitive tests, cerebrospinal fluid biomarkers, and automated magnetic resonance imaging features for pairwise differentiation between dementia types.

Results: Cognitive tests had good performance in separating any type of dementia from controls. Cerebrospinal fluid optimally contributed to identifying Alzheimer’s disease, whereas magnetic resonance imaging features aided in separating vascular dementia, dementia with Lewy bodies, and frontotemporal dementia. Combining diagnostic tests increased the accuracy, with balanced accuracies ranging from 78% to 97%.

Conclusions: Different diagnostic tests have their distinct roles in differential diagnostics of dementias. Our results indicate that combining different diagnostic tests may increase the accuracy further.

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Series: Alzheimer's & dementia. Diagnosis, assessment & disease monitoring
ISSN: 2352-8729
ISSN-E: 2352-8729
ISSN-L: 2352-8729
Volume: 10
Pages: 509 - 518
DOI: 10.1016/j.dadm.2018.07.003
OADOI: https://oadoi.org/10.1016/j.dadm.2018.07.003
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Subjects:
Alzheimer's disease
Biomarkers
CSF
Clinical decision support system
Dementia with Lewy bodies
Diagnostic test assessment
Differential diagnosis
Frontotemporal dementia
MRI
Vascular dementia
Article
Funding: This project has received funding from the European Union's Seventh Framework Programme for research, technological development and demonstration under grant agreements no 611005 (PredictND). For development of the PredictND tool, the VTT Technical Research Center of Finland Ltd has received funding from European Union's Seventh Framework Programme for research, technological development, and demonstration under grant agreements 601055 (VPH-DARE@IT), 224328, and 611005. The PredictND consortium consisted of collaborates from the VTT Technical Research Center of Finland, GE Healthcare Ltd, Imperial College London, Alzheimer Europe, Alzheimer Center–VU University Medical Center, Amsterdam, the Netherlands, the Danish Dementia Research Center, Copenhagen University Hospital, Denmark, the Department of Gerontology and Geriatrics of the University of Perugia, “S. Maria della Misericordia” Hospital of Perugia, Italy, the Department of Neurology from the University of Eastern Finland.
Dataset Reference: Supplementary Appendices:
  https://ars.els-cdn.com/content/image/1-s2.0-S2352872918300435-mmc1.docx
Copyright information: © 2018 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
  https://creativecommons.org/licenses/by-nc-nd/4.0/