Guidelines for the use and interpretation of Alzheimer's disease biomarkers in clinical practice in Brazil: recommendations from the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology.
Adalberto Studart-Neto, Breno José Alencar Pires Barbosa, Artur Martins Coutinho, Leonardo Cruz de Souza, Lucas Porcello Schilling, Mari Nilva Maia da Silva, Raphael Machado Castilhos, Paulo Henrique Ferreira Bertolucci, Wyllians Vendramini Borelli, Hélio Rodrigues Gomes, Gustavo Bruniera Peres Fernandes, Maira Tonidandel Barbosa, Marcio Luiz Figueredo Balthazar, Norberto Anízio Ferreira Frota, Orestes Vicente Forlenza, Jerusa Smid, Sonia Maria Dozzi Brucki, Paulo Caramelli, Ricardo Nitrini, Eliasz Engelhardt, Elisa de Paula França Resende
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Abstract
In recent years, the diagnostic accuracy of Alzheimer's disease has been enhanced by the development of different types of biomarkers that indicate the presence of neuropathological processes. In addition to improving patient selection for clinical trials, biomarkers can assess the effects of new treatments on pathological processes. However, there is concern about the indiscriminate and poorly supported use of biomarkers, especially in asymptomatic individuals or those with subjective cognitive decline. Difficulties interpreting these tests, high costs, and unequal access make this scenario even more challenging in healthcare. This article presents the recommendations from the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology (Departamento Científico de Neurologia Cognitiva e Envelhecimento da Academia Brasileira de Neurologia) regarding the rational use and interpretation of Alzheimer's disease biomarkers in clinical practice. The clinical diagnosis of cognitive-behavioral syndrome is recommended as the initial step to guide the request for biomarkers.
近年来，通过开发不同类型的生物标记物来显示神经病理过程的存在，阿尔茨海默病诊断的准确性得到了提高。生物标志物除了可以改善临床试验对患者的选择外，还可以评估新疗法对病理过程的影响。然而，人们对生物标记物的滥用和缺乏支持表示担忧，尤其是在无症状或主观认知能力下降的人群中。解释这些测试的困难、高昂的成本和不平等的获取途径使这种情况在医疗保健领域更具挑战性。本文介绍了巴西神经病学学会认知神经学和老龄化科学部（Departamento Científico de Neurologia Cognitiva e Envelhecimento da Academia Brasileira de Neurologia）就在临床实践中合理使用和解释阿尔茨海默病生物标志物提出的建议。建议将认知行为综合征的临床诊断作为指导生物标记物申请的第一步。
期刊介绍：
Dementia top Neuropsychologia the official scientific journal of the Cognitive Neurology and Ageing Department of the Brazilian Academy of Neurology and of the Brazilian Association of Geriatric Neuropsychiatry, is published by the "Associação Neurologia Cognitiva e do Comportamento", a nonprofit Brazilian association. Regularly published on March, June, September, and December since 2007.
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