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Table 1 Biomarkers for diagnosis of dementias

From: Fluid biomarkers for diagnosing dementia: rationale and the Canadian Consensus on Diagnosis and Treatment of Dementia recommendations for Canadian physicians

Neuropathological process Process of interest Method Outcome Interpretation
Amyloid deposition Fibrillar amyloid availability [11C]Pittsburgh compound B PET Increased brain retention Amyloid depositiona
  Fibrillar amyloid availability [18F]Florbetapir PET Increased brain retention Amyloid depositiona
  Fibrillar amyloid availability [18F]Florbetapen PET Increased brain retention Amyloid depositiona
  Fibrillar amyloid availability [18F]Flutametamol PET Increased brain retention Amyloid depositiona
 1-42 CSF concentrations Lumbar puncture Declined in CSF concentration Amyloid deposition [2, 4, 5]
 1-42 serum levels Lumbar puncture Declined in serum concentration Amyloid deposition [2, 4, 5]
Neurodegeneration (downstream) Brain metabolism or perfusion [18F]FDG PET or [99Tc]HMPAO/
ECD SPECT
Brain hypometabolism/perfusion in parietotemporal regions Synaptic depletiona
  Total tau CSF concentrations Lumbar puncture Increased CSF concentration Cell death [2, 4, 5]
  Tau-181 CSF concentrations Lumbar puncture Increased CSF concentration Tau phosphorylation [2, 4, 5]5
  Brain atrophy MRI Decreased volume loss Atrophya
  Fibrillar tau accumulation PET Increased of retention Tangle depositiona
Non-Alzheimer's disease biomarkers Brain lesions MRI Exclusion of alternative pathologies Tumor, cerebrovascular diseasea
  Brain metabolism or perfusion [18F]FDG PET or [99Tc]HMPAO/
ECD SPECT
Brain hypometabolism/perfusion in occipital regions or asymmetric frontotemporal regions Diagnoses of LBD or FTD, respectivelya
  Dopamine transporter availability [123I]Ioflupane (DAT) SPECT Reduced uptake in basal ganglia Reduction of dopamine transporters typical of LBD and other Parkinsonian syndromesa
  Inflammation FLAIR MRI Increased T2* signal Parenchymal lesiona
  Hemosiderin Susceptibility MRI Loss on gradient-recalled echo Hemosiderin leakage and macrophages in the brain parenchymaa
  1. 1-42, amyloid-beta; CSF, cerebrospinal fluid; DAT, DopAmine Transporter; FDG, fluorodeoxyglucose; FLAIR, fluid attenuated inversion recovery; FTD, frontotemporal dementia; HMPAO/ECD, (99mTc) exametazime, (99mTc) -ethylcysteinate dimer; LBD, Lewy body dementia; MRI, magnetic resonance imaging; PET, positron emission tomography; SPECT, Single-photon emission computed tomography. aSee associated Canadian Consensus Conference on Diagnosis and Treatment of Dementia publications on biomarkers.