Marc Teichmann1, Stéphane Epelbaum2, Dalila Samri3, Marcel Levy Nogueira4, Agnès Michon3, Harald Hampel5, Foudil Lamari6, Bruno Dubois7. 1. Department of Neurology, Institut de la mémoire et de la maladie d'Alzheimer, Centre de Référence 'Démences Rares', Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France; Institut du Cerveau et de la Moelle Epinière (ICM), ICM-INSERM 1127, FrontLab, Paris, France. Electronic address: marc.teichmann@psl.aphp.fr. 2. Department of Neurology, Institut de la mémoire et de la maladie d'Alzheimer, Centre de Référence 'Démences Rares', Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France; Institut du Cerveau et de la Moelle Epinière (ICM), ICM-INSERM 1127, Team Alzheimer's and Prions Diseases, Paris, France. 3. Department of Neurology, Institut de la mémoire et de la maladie d'Alzheimer, Centre de Référence 'Démences Rares', Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France. 4. Department of Neurology, Institut de la mémoire et de la maladie d'Alzheimer, Centre de Référence 'Démences Rares', Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France; Ecole Polytechnique, LIX, Paris-Saclay University, Palaiseau, France. 5. Department of Neurology, Institut de la mémoire et de la maladie d'Alzheimer, Centre de Référence 'Démences Rares', Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France; AXA Research Fund and UPMC, Sorbonne Universities, Pierre and Marie Curie University, Paris 06, INSERM, CNRS, Brain and Spine Institute (ICM), Paris, France. 6. Department of Metabolic Biochemistry, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France. 7. Department of Neurology, Institut de la mémoire et de la maladie d'Alzheimer, Centre de Référence 'Démences Rares', Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France; Institut du Cerveau et de la Moelle Epinière (ICM), ICM-INSERM 1127, FrontLab, Paris, France.
Abstract
INTRODUCTION: The International Working Group recommended the Free and Cued Selective Reminding Test (FCSRT) as a sensitive detector of the amnesic syndrome of the hippocampal type in typical Alzheimer's disease (AD). But does it differentiate AD from other neurodegenerative diseases? METHODS: We assessed the FCSRT and cerebrospinal fluid (CSF) AD biomarkers in 992 cases. Experts, blinded to biomarker data, attributed in 650 cases a diagnosis of typical AD, frontotemporal dementia, posterior cortical atrophy, Lewy body disease, progressive supranuclear palsy, corticobasal syndrome, primary progressive aphasias, "subjective cognitive decline," or depression. RESULTS: The FCSRT distinguished typical AD from all other conditions with a sensitivity of 100% and a specificity of 75%. Non-AD neurodegenerative diseases with positive AD CSF biomarkers ("atypical AD") did not have lower FCSRT scores than those with negative biomarkers. DISCUSSION: The FCSRT is a reliable tool for diagnosing typical AD among various neurodegenerative diseases. At an individual level, however, its specificity is not absolute. Our findings also widen the spectrum of atypical AD to multiple neurodegenerative conditions.
INTRODUCTION: The International Working Group recommended the Free and Cued Selective Reminding Test (FCSRT) as a sensitive detector of the amnesic syndrome of the hippocampal type in typical Alzheimer's disease (AD). But does it differentiate AD from other neurodegenerative diseases? METHODS: We assessed the FCSRT and cerebrospinal fluid (CSF) AD biomarkers in 992 cases. Experts, blinded to biomarker data, attributed in 650 cases a diagnosis of typical AD, frontotemporal dementia, posterior cortical atrophy, Lewy body disease, progressive supranuclear palsy, corticobasal syndrome, primary progressive aphasias, "subjective cognitive decline," or depression. RESULTS: The FCSRT distinguished typical AD from all other conditions with a sensitivity of 100% and a specificity of 75%. Non-AD neurodegenerative diseases with positive AD CSF biomarkers ("atypical AD") did not have lower FCSRT scores than those with negative biomarkers. DISCUSSION: The FCSRT is a reliable tool for diagnosing typical AD among various neurodegenerative diseases. At an individual level, however, its specificity is not absolute. Our findings also widen the spectrum of atypical AD to multiple neurodegenerative conditions.
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