Atypical Early-Onset Alzheimer’s Disease Dementia Diagnosed by Biomarker Study
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Background The described clinical characteristics of early-onset Alzheimer’s disease (EOAD) are distinct from that of late-onset AD. Wereported a patient with atypical EOAD. Case Report A 54-year-old, truck driver developed gradual visuospatial, language and calculation deficits for 3 months. The neuropsychologicalimpairments were extensive. Brain MRI revealed asymmetric atrophy in left medial temporal lobe along with distinct widening of sylvianfissure. (18)F-florbetapir-positron emission tomography (PET) showed a high uptake in the cortex. Further, the profiles of cerebrospinalfluid (CSF) biomarker were compatible with AD. Conclusions We diagnosed the patient as EOAD based on the result of biomarker study. Increased Aß burden was identified through amyloidPET imaging and decreased CSF Aβ level. The high rise of CSF Tau proteins was in agreement with the patient’s extensive and rapidcognitive decline. This case report demonstrates the importance of AD biomarker study in confronting early-onset dementia with atypicalclinical presentation.
Abstract
Background The described clinical characteristics of early-onset Alzheimer’s disease (EOAD) are distinct from that of late-onset AD. Wereported a patient with atypical EOAD. Case Report A 54-year-old, truck driver developed gradual visuospatial, language and calculation deficits for 3 months. The neuropsychologicalimpairments were extensive. Brain MRI revealed asymmetric atrophy in left medial temporal lobe along with distinct widening of sylvianfissure. (18)F-florbetapir-positron emission tomography (PET) showed a high uptake in the cortex. Further, the profiles of cerebrospinalfluid (CSF) biomarker were compatible with AD. Conclusions We diagnosed the patient as EOAD based on the result of biomarker study. Increased Aß burden was identified through amyloidPET imaging and decreased CSF Aβ level. The high rise of CSF Tau proteins was in agreement with the patient’s extensive and rapidcognitive decline. This case report demonstrates the importance of AD biomarker study in confronting early-onset dementia with atypicalclinical presentation.
참고문헌 (17)
- Rossor MN, "The diagnosis of young-onset dementia", Lancet Neurol, 9, pp.793~806 (2010)
- Koedam EL, "Early-versus late-onset Alzheimer’s disease:more than age alone", J Alzheimers Dis, 19, pp.1401~1408 (2010)
- Panegyres PK, "Differences between early and late onset Alzheimer’s disease", Am J Neurodegener Dis, 2, pp.300~306 (2013)
- 안현정, "Seoul Neuropsychological Screening Battery-Dementia Version (SNSB-D): A Useful Tool for Assessing and Monitoring Cognitive Impairments in Dementia Patients", Journal of Korean Medical Science, 25(7), pp.1071~1076 (2010), 대한의학회
- Damasio H, "The anatomical basis of conduction aphasia", Brain, 103, pp.337~350 (1980)
- 박선아, "알츠하이머병 뇌척수액 생물표지자 다기관 연구를 위한 예비연구", Dementia and Neurocognitive Disorders(대한치매학회지), 12(1), pp.1~8 (2013), 대한치매학회[DOI]
- Panegyres PK, "Early-onset Alzheimer’s disease: a global cross-sectional analysis", Eur J Neurol, 21, pp.1149~1154 (2014)
- Dubois B, "Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria", Lancet Neurol, 13, pp.614~629 (2014)
- McKhann GM, "The diagnosis of dementia due to Alzheimer’s disease:recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease", Alzheimers Dement, 7, pp.263~269 (2011)
- Fagan AM, "Upcoming candidate cerebrospinal fluid biomarkers of Alzheimer’s disease", Biomark Med, 6, pp.455~476 (2012)
- Hampel H, "Core candidate neurochemical and imaging biomarkers of Alzheimer’s disease", Alzheimers Dement, 4, pp.38~48 (2008)
- Hansson O, "Association between CSF biomarkers and incipient Alzheimer’s disease in patients with mild cognitive impairment: a follow-up study", Lancet Neurol, 5, pp.228~234 (2006)
- Molinuevo JL, "The clinical use of cerebrospinal fluid biomarker testing for Alzheimer’s disease diagnosis: a consensus paper from the Alzheimer’s Biomarkers Standardization Initiative", Alzheimers Dement, 10, pp.808~817 (2014)
- Mendez MF, "Nonamnestic presentations of early-onset Alzheimer’s disease", Am J Alzheimers Dis Other Demen, 27, pp.413~420 (2012)
- Mendez MF, "Atypical conduction aphasia. A disconnection syndrome", Arch Neurol, 42, pp.886~891 (1985)
- Adriaanse SM, "Widespread disruption of functional brain organization in early-onset Alzheimer’s disease", PLoS One, 9, pp.e102995~ (2014)
- Gour N, "Functional connectivity changes differ in early and late-onset Alzheimer’s disease", Hum Brain Mapp, 35, pp.2978~2994 (2014)