Article

The diagnosis of Alzheimer's disease (AD) and its related disorders
rely on clinical criteria. There is, however, a large clinical overlap between
the different neurodegenerative diseases affecting cognition and, frequently,
there are diagnostic uncertainties with atypical clinical presentations. Current
clinical practices can now regularly use positron emission tomography (PET) and
single-photon emission computed tomography (SPECT) molecular imaging to help
resolve such uncertainties. The Neurology Group of the French Society of Nuclear
Medicine and Federations of Memory, Resources and Research Centers have
collaborated to establish clinical guidelines to determine which molecular
imaging techniques to use when seeking a differential diagnosis between AD and
other neurodegenerative disorders affecting cognition. STATE OF KNOWLEDGE:
According to the current medical literature, the potential usefulness of
molecular imaging to address the typical clinical criteria in common forms of AD
remains modest, as typical AD presentations rarely raise questions of
differential diagnoses with other neurodegenerative disorders. However, molecular
imaging could be of significant value in the diagnosis of atypical
neurodegenerative disorders, including early onset, rapid cognitive decline,
prominent non-amnestic presentations involving language, visuospatial,
behavioral/executive and/or non-cognitive symptoms in AD, or prominent amnestic
presentations in other non-AD dementias. CONCLUSION AND PERSPECTIVE: The clinical
use of molecular imaging should be recommended for assessing cognitive
disturbances particularly in patients with early clinical onset (before age 65)
and atypical presentations. However, diagnostic tools should always be part of
the global clinical approach, as an isolated positive result cannot adequately
establish a diagnosis of any neurodegenerative disorder.
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Langue : ANGLAIS