A new diagnostic tool helps clinicians to differentiate between Alzheimer’s disease, frontotemporal dementia and mild cognitive impairment. Presented by Dr M. Ruiz at the University of Eastern Finland, the new method consists of a Disease State Index combining data from multiple sources, and of a Disease State Fingerprint showing the findings in a visual format.
It is estimated that more than 35.6 million people are living with dementia worldwide. This number will increase in the coming years and there is a need to identify these patients to provide them with proper treatment as early as possible. The differential diagnosis of the dementia diseases represents a challenge particularly in the early phases. Many studies have focused on predicting the possible conversion from mild cognitive impairment, a pre-dementia stage, to Alzheimer’s disease (AD), the most common dementia disease. Several methods have also been proposed for differentiating between AD and frontotemporal dementia (FTD), another relatively common degenerative dementia. An early and precise diagnosis of these two dementia diseases is needed in order to benefit from treatments designed to influence the disease mechanisms.
In recent years, important advances have been made especially in the development of new diagnostic methods. Several biomarkers and tests are used in clinical practice, such as cerebrospinal fluid biomarkers, imaging methods, genetic profiling and neuropsychological tests. However, making a differential diagnosis is not easy due to overlapping clinical and biomarker findings in the interpretation of all this multitude of data. Furthermore, there is no single biomarker or test which could clearly define whether a patient is suffering from AD or FTD.
The approach of Dr Ruiz (Structural MRI in Frontotemporal Dementia: Comparisons between Hippocampal volumetry, Tensor-based morphometry and Voxel-based morphometry. PLoS ONE 7(12): e52531). introduces a new combination of different methods for the differential diagnosis of AD, mild cognitive impairment and FTD, and describes a tool comprising a Disease State Index and its visual counterpart, a Disease State Fingerprint.
The software combines data from multiple sources such as psychological tests and brain MRI, and uses this data to create a Disease State Index, with a range of values between 0 and 1. In a healthy person, the index is close to 0, while an index close to 1 is an indicator of dementia. The Disease State Fingerprint shows the findings in an easy-to-interpret format in which the key findings are clearly indicated by color and size.
With the help of the new diagnostic tool, clinicians could determine which methods are more relevant for profiling a patient with a certain dementia disease, e.g. whether it is mild cognitive impairment, FTD or AD. Even the first visit, the clinician could make a first diagnosis to initiate treatment and to counsel to the patient.