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Life Long Learning in Neurology - part 8

Đối tượng bị trầm cảm là một cách dễ dàng kiểm tra các thử nghiệm trả lời đúng: Câu trả lời đúng là A. Mang trong tâm trí hãy cẩn thận trên cũng như các yếu tố văn hóa, ngôn ngữ, và có thể đã ảnh hưởng đến các thử nghiệm lâm sàng lớn trong aMCI, tác giả kết luận rằng tỷ lệ chuyển đổi | 131 E. Subjects with depression are easily screened out of trials Correct Answer The correct answer is A. Bearing in mind the caveats above as well as cultural linguistic and other factors that may have influenced large clinical trials in aMCI the author concludes that the high rate of conversion of study subjects from aMCI to AD minimally double or triple the conversion rate in the general population points to a valuable group of subjects for future clinical trials. The author notes that MCI while a difficult concept for some hysicians has been well received in the modern literature and has proven a useful group of patients to enter into clinical trials. APOE4 carriers do skew conversion rates from aMCI to AD screening subjects with depression out of clinical trials is felt to have influenced for example the rivastigmine trial s lower conversion rate to AD. Donepezil did show a treatment benefit for 12 months in all subjects and up to 24 months in APOE subjects. 23. Which of the following studies has been used with accuracy to follow progression of Alzheimer s disease A. FDG-PET scans for increasing areas of decreased parietal metabolism B. Genotyping for APOE4 status C. Serial lumbar punctures for A beta 1-42 protein levels D. Serial lumbar punctures for CSF tau levels E. Structural MRI for hippocampal and brain volume Correct Answer The correct answer is E. Although many techniques and biomarkers are currently under study of the above studies only choice E with demonstration of continuing loss of hippocampal and whole brain volume has been demonstrated to correlate well with clinical progression of Alzheimer s disease. A beta 1-42 and tau levels in CSF have some correlation when a diagnosis is being established but they are felt to have some overlap with normal aging and have not been used to study disease progression. PET scans have utility again in establishing a diagnosis but at this point have not proven practical in following disease progression genetic .