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      Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria.

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          Abstract

          In the past 8 years, both the International Working Group (IWG) and the US National Institute on Aging-Alzheimer's Association have contributed criteria for the diagnosis of Alzheimer's disease (AD) that better define clinical phenotypes and integrate biomarkers into the diagnostic process, covering the full staging of the disease. This Position Paper considers the strengths and limitations of the IWG research diagnostic criteria and proposes advances to improve the diagnostic framework. On the basis of these refinements, the diagnosis of AD can be simplified, requiring the presence of an appropriate clinical AD phenotype (typical or atypical) and a pathophysiological biomarker consistent with the presence of Alzheimer's pathology. We propose that downstream topographical biomarkers of the disease, such as volumetric MRI and fluorodeoxyglucose PET, might better serve in the measurement and monitoring of the course of disease. This paper also elaborates on the specific diagnostic criteria for atypical forms of AD, for mixed AD, and for the preclinical states of AD.

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          Author and article information

          Journal
          Lancet Neurol
          The Lancet. Neurology
          Elsevier BV
          1474-4465
          1474-4422
          Jun 2014
          : 13
          : 6
          Affiliations
          [1 ] Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France. Electronic address: bruno.dubois@psl.aphp.fr.
          [2 ] Division of Neurology, University of British Columbia and Vancouver Coastal Health, Vancouver, BC, Canada.
          [3 ] UBC Division of Neurology, S152 UBC Hospital, BC, Canada.
          [4 ] Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France.
          [5 ] Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, IDIBAPS Hospital Clinici Universitari, Barcelona, Spain; BarcelonaBeta Brain Research Centre, Fundació Pasqual Maragall, Barcelona, Spain.
          [6 ] Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden.
          [7 ] Department of Neurology, University of Virginia, Charlottesville, VA, USA.
          [8 ] McGill Center for Studies in Aging, Douglas Hospital, Montreal, Quebec, QC, Canada.
          [9 ] Harvard Medical School Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, MA, USA.
          [10 ] Washington University School of Medicine, St Louis, Missouri, MO, USA.
          [11 ] Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neurosciences, Cognitive Neurorehabilitation, Milan, Italy.
          [12 ] Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London, London, UK; Dementia Research Centre, National Hospital, London, UK.
          [13 ] Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA), Middelheim and Hoge Beuken, Antwerp, Belgium; Reference Centre for Biological Markers of Dementia, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.
          [14 ] Hopitaux Universitaires et Université de Genève, Geneva, Switzerland; IRCCS Fatebenefratelli, Brescia, Italy; HUG Belle-Idée, bâtiment les Voirons, Chêne-Bourg, France.
          [15 ] Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London, London, UK.
          [16 ] Department of Neurosciences, -University of California, San Diego, CA, USA.
          [17 ] INSERM UMR, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Médecine Nucléaire, Paris, France.
          [18 ] University of Kentucky Alzheimer's Disease Center, Lexington, KY, USA.
          [19 ] Karolinska Institutet, Karolinska University Hospital Huddinge, Alzheimer Neurobiology Center, Stockholm, Sweden.
          [20 ] Université Lille Nord de France, Lille, France; CHRU, Clinique Neurologique, Hôpital Roger Salengro, Lille, France.
          [21 ] UCSF Memory & Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.
          [22 ] EA CoBTeK and Memory Center, CHU University of Nice, UNSA, Hôpital de Cimiez 4 av Victoria, Nice, France.
          [23 ] FRACP, Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Melbourne, VIC, Australia.
          [24 ] Neurology and the Memory and Aging Program, Butler Hospital, Department of Neurology and Psychiatry, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
          [25 ] Neurologie de la Mémoire et du Langage, Centre Hospitalier Sainte-Anne, Paris Cedex, France; Université Paris 5, Paris, France.
          [26 ] Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France; Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
          [27 ] Gerontopole, Pavillon Junod, University Toulouse 3, Toulouse, France.
          [28 ] Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands; Department of Neurology and Alzheimer Center, Amsterdam, Netherlands.
          [29 ] Department of Psychiatry, Neurology, and Gerontology, Keck School of Medicine of USC, Los Angeles, CA, USA.
          [30 ] Cognitive Neuroscience Division of the Taub Institute, Presbyterian Hospital, New York, NY, USA.
          [31 ] Alzheimer Centrum Vrije Universiteit Medical Center, VU University, Amsterdam, Netherlands.
          [32 ] Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, NV, USA.
          Article
          S1474-4422(14)70090-0
          10.1016/S1474-4422(14)70090-0
          24849862
          22e5dc89-6abe-4e9b-b514-be7caa58ab99
          History

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