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RESEARCH PRODUCT

Validating the DemTect with 18-Fluoro-2-Deoxy-Glucose Positron Emission Tomography as a Sensitive Neuropsychological Screening Test for Early Alzheimer Disease in Patients of a Memory Clinic

Armin ScheurichAndreas FellgiebelMatthias J. MüllerLutz G. SchmidtThomas SiessmeierPeter Bartenstein

subject

MalePathologymedicine.medical_specialtyCognitive NeuroscienceNeuropsychological TestsCognitionAlzheimer DiseaseFluorodeoxyglucose F18MemorymedicineHumansDementiaAgedmedicine.diagnostic_testbusiness.industryCognitive disorderMemory clinicNeuropsychologyInfarction Middle Cerebral ArteryMagnetic resonance imagingNeuropsychological testMiddle Agedmedicine.diseasePsychiatry and Mental healthROC CurvePositron emission tomographyData Interpretation StatisticalPositron-Emission TomographyMental RecallFemaleRadiopharmaceuticalsGeriatrics and GerontologyAlzheimer's diseasePsychologyNuclear medicinebusiness

description

<i>Objectives:</i> The first study to validate the diagnostic value of the DemTect, a short neuropsychological screening test for dementia (8–10 min), using 18-fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) in patients of a memory clinic. <i>Methods:</i> DemTect results were compared to the clinical diagnosis and to FDG-PET as a reference method for the early in vivo detection of Alzheimer’s disease (AD). <i>Results:</i> 38 patients (age 65.2 ± 9.8 years, 16 men, 22 women) were investigated using clinical standard examination, FDG-PET, and cranial magnetic resonance imaging. According to NINCDS-ADRDA and Petersen’s criteria, 18 patients had dementia of the Alzheimer type (DAT) and 13 patients received the diagnosis of mild cognitive impairment (MCI). Compared to the clinical diagnosis, a DemTect cutoff score of ≤11 points demonstrated good sensitivity (83.3%) and specificity (70.0%) for the detection of DAT, whereas the best cutoff score for MCI was ≤13 points with comparable sensitivity (84.6%) and specificity (85.7%). With regard to FDG-PET, the DemTect demonstrated excellent sensitivity (93%) and low specificity (50%) for the detection of AD-typical patterns of cerebral glucose metabolism (cutoff ≤13 points). <i>Conclusion:</i> DemTect is a favorable neuropsychological screening instrument for detecting cognitive dysfunction even in predementia stages of AD. For definite cross-sectional diagnosis, further diagnostic evaluation with higher specificity, e.g. comprehensive neuropsychological examination, FDG-PET or other biomarkers, is necessary.

https://doi.org/10.1159/000088248