Mathias Holsey Gramkow, Frederikke Kragh Clemmensen, Nikolai Sulkjær Sjælland, Gunhild Waldemar, Steen Gregers Hasselbalch, Kristian Steen Frederiksen
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引用次数: 0
摘要
由于最近批准了一些改变疾病的疗法，因此迫切需要一些易于应用的诊断工具，如阿尔茨海默病（AD）的数字生物标记物。我们的目的是在一项概念验证横断面研究中确定手持式定量光反射瞳孔测定法（qLRP）在阿尔茨海默病患者中的诊断性能。参与者于2022年8月至2023年10月在一所大学的记忆诊所接受了qLRP检查。我们建立了以qLRP、性别和年龄为预测因素的多变量逻辑回归模型，并以接收者操作特征曲线下面积（AUROC）进行评估。共纳入了 107 名 AD 患者、44 名混合型 AD 和血管认知功能障碍（VCD）患者、53 名路易体痴呆（DLB）患者和 50 名健康对照组（HC）。我们的诊断模型在区分 AD 患者和 HC 及其他痴呆症时显示出相似的鉴别能力（AUROC 范围为 0.74-0.81）。作为一种床旁数字生物标记物，qLRP似乎很有希望帮助诊断AD：我们证明了qLRP在阿尔茨海默病中的诊断性能，诊断模型在敏感性分析中表现稳健。
Diagnostic performance of light reflex pupillometry in Alzheimer's disease.
Easily applied diagnostic tools such as digital biomarkers for Alzheimer's disease (AD) are urgently needed due to the recent approval of disease-modifying therapies. We aimed to determine the diagnostic performance of hand-held, quantitative light reflex pupillometry (qLRP) in patients with AD in a proof-of-concept, cross-sectional study. Participants underwent qLRP at a university memory clinic from August 2022 to October 2023. We fitted multivariable logistic regression models with qLRP, sex, and age as predictors evaluated with area under the receiver operating characteristics curve (AUROC). In total, 107 patients with AD, 44 patients with mixed AD and vascular cognitive dysfunction (VCD), 53 patients with dementia with Lewy bodies (DLB), and 50 healthy controls (HCs) were included. Our diagnostic models showed similar discriminatory ability (AUROC range 0.74-0.81) when distinguishing patients with AD from HCs and other dementias. The qLRP seems promising as a bedside digital biomarker to aid in diagnosing AD.
Highlights: We demonstrated the diagnostic performance of qLRP in Alzheimer's disease.The diagnostic models were robust in sensitivity analyses.qLRP may assist in the bedside diagnostic evaluation of Alzheimer's disease.
期刊介绍：
Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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