Consensus classification of posterior cortical atrophy.
Consensus classification of posterior cortical atrophy.
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DOI：
10.1016/j.jalz.2017.01.014
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发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Alzheimer's Association ISTAART Atypical Alzheimer's Disease and Associated Syndromes Professional Interest Area
中科院分区：
文献类型：
--
作者：
Crutch SJ;Schott JM;Rabinovici GD;Murray M;Snowden JS;van der Flier WM;Dickerson BC;Vandenberghe R;Ahmed S;Bak TH;Boeve BF;Butler C;Cappa SF;Ceccaldi M;de Souza LC;Dubois B;Felician O;Galasko D;Graff-Radford J;Graff-Radford NR;Hof PR;Krolak-Salmon P;Lehmann M;Magnin E;Mendez MF;Nestor PJ;Onyike CU;Pelak VS;Pijnenburg Y;Primativo S;Rossor MN;Ryan NS;Scheltens P;Shakespeare TJ;Suárez González A;Tang-Wai DF;Yong KXX;Carrillo M;Fox NC;Alzheimer's Association ISTAART Atypical Alzheimer's Disease and Associated Syndromes Professional Interest Area
提出了后部皮质萎缩(PCA)的分类框架，以提高在各种研究环境中对该综合征定义的一致性。通过详细的文献审查，成立了一个国际多学科工作组，召开了四次会议，并对自发性自发性疼痛的症状频率和概念化进行了一次基于网络的量化调查，从而形成了关于自发性自发性疼痛的共识声明。描述了一种用于主成分分析的三级分类框架，包括症状级描述和疾病级描述。分类级别1(PCA)定义了临床放射综合征的核心临床、认知和神经影像特征和排除标准。2级分类(Pca-Pure，Pca-Plus)确定除了核心的PCA综合征外，是否还存在任何其他神经退行性综合征的核心特征。分类级别3(可归因于AD[PCA-AD]、路易体疾病[PCA-LBD]、皮质基底部变性[PCA-CBD]、Pron病[PCA-Prion])基于现有的病理生理学生物标记物证据，提供了对PCA综合征潜在原因的更正式的确定。另外的症状水平描述符的问题被讨论与定义症状严重程度的阶段和在主成分分析谱内表征表型异质性的挑战有关。对于核心临床-放射综合征的定义有很大的共识，这意味着目前的共识声明应该被视为先前单中心PCA标准的精炼、发展和延伸，而不是对该综合征的任何大规模改变或重新描述。框架和术语可以促进跨研究的研究数据的解释，适用于广泛的研究情景(例如，行为干预、药理学试验)，并为未来的协作工作提供基础。
A classification framework for posterior cortical atrophy (PCA) is proposed to improve the uniformity of definition of the syndrome in a variety of research settings. Consensus statements about PCA were developed through a detailed literature review, the formation of an international multidisciplinary working party which convened on four occasions, and a Web-based quantitative survey regarding symptom frequency and the conceptualization of PCA. A three-level classification framework for PCA is described comprising both syndrome- and disease-level descriptions. Classification level 1 (PCA) defines the core clinical, cognitive, and neuroimaging features and exclusion criteria of the clinico-radiological syndrome. Classification level 2 (PCA-pure, PCA-plus) establishes whether, in addition to the core PCA syndrome, the core features of any other neurodegenerative syndromes are present. Classification level 3 (PCA attributable to AD [PCA-AD], Lewy body disease [PCA-LBD], corticobasal degeneration [PCA-CBD], prion disease [PCA-prion]) provides a more formal determination of the underlying cause of the PCA syndrome, based on available pathophysiological biomarker evidence. The issue of additional syndrome-level descriptors is discussed in relation to the challenges of defining stages of syndrome severity and characterizing phenotypic heterogeneity within the PCA spectrum. There was strong agreement regarding the definition of the core clinico-radiological syndrome, meaning that the current consensus statement should be regarded as a refinement, development, and extension of previous single-center PCA criteria rather than any wholesale alteration or redescription of the syndrome. The framework and terminology may facilitate the interpretation of research data across studies, be applicable across a broad range of research scenarios (e.g., behavioral interventions, pharmacological trials), and provide a foundation for future collaborative work.
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