Preliminary evidence of validity of the revised criteria for Alzheimer disease diagnosis: report of 2 cases.
OBJECTIVE
Revised research criteria for the diagnosis of Alzheimer disease have been proposed to capture patients presenting with mild and not yet disabling symptoms, and currently classified as mild cognitive impairment (MCI). We describe 2 very mild cases of MCI and their clinical outcome.


METHODS
The 2 cases were selected as they had unequivocal preservation of daily activities and normal global cognitive performance (Mini-Mental State Examination 29/30) and were positive to all 3 markers. Cognitive profile was assessed with an extensive neuropsychologic battery, medial temporal atrophy with hippocampal volumetry, hypometabolism on F-deoxyglucose positron emission tomography and voxel-based statistical parametric mapping analysis, and tau and amyloid beta-42 in the cerebrospinal fluid with enzyme-linked immunosorbent assay.


RESULTS
Both patients had a poor performance in 2 out of 11 neuropsychologic tests. Both had hippocampal volumes at or below the first percentile of the age-specific distribution, retrosplenial glucose hypometabolism, and inversion of tau/amyloid beta-42 cerebrospinal fluid ratio. Both showed progression of the cognitive deficit over the following 12 months.


CONCLUSIONS
These 2 patients with progressive MCI and positivity to all Alzheimer markers predicated by the new research criteria provide preliminary support to their validity. Future work will characterize the marker profile of the vast majority of patients with incomplete marker positivity.
Frisoni
Giovanni B
GB
Associazione Fatebenefratelli per la Ricerca Biomedica e Sanitaria, Rome, Italy. gfrisoni@fatebenefratelli.it
Galluzzi
Samantha
S
Signorini
Matteo
M
Garibotto
Valentina
V
Paghera
Barbara
B
Binetti
Giuliano
G
Canu
Elisa
E
Geroldi
Cristina
C
Perani
Daniela
D
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis*; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D003072:Cognition Disorders / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D016875:tau Proteins / Q000134:cerebrospinal fluid
D016229:Amyloid beta-Peptides; D016875:tau Proteins