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Neurobiol Aging. 2017 Apr;52:119-131. doi: 10.1016/j.neurobiolaging.2016.02.033.

Biomarkers for the diagnosis of Alzheimer's disease in clinical practice: an Italian intersocietal roadmap.

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IRCCS Fatebenefratelli, Brescia, Italy; Memory Clinic - Department of Internal Medicine, University Hospital of Geneva, Geneva, Switzerland; LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland. Electronic address:
Vita-Salute San Raffaele University, Nuclear Medicine Unit San Raffaele Hospital, Division of Neuroscience San Raffaele Scientific Institute, Milano, Italy; Italian Association of Nuclear Medicine (AIMN).
Neuroradiology, Department of Brain and Behavioral Sciences, University of Pavia, IRCCS Casimiro Mondino National Neurological Institute, Pavia, Italy; Italian Association of Neuroradiology (AINR).
UO Patologia clinica e Genetica medica, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy; Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC).
IRCCS Fatebenefratelli, Brescia, Italy; Bioethics and Palliative Care Study Group of the Italian Society of Neurology.
IRCCS Fatebenefratelli, Brescia, Italy; LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland.
IUSS Pavia and Division of Neuroscience, IRCCS San Raffaele, Milano, Italy; Italian Neuropsychological Society (SINP).
Università Tor Vergata, Roma, Italy; Italian PsychogeriatricsAssociation (AIP).
Clinica Neurologica, Dipartimento Scienze Cliniche e Sperimentali, Università di Brescia, Brescia, Italy; Italian Society of Neurology - Association for the Study of the Dementias (SINdem).


Biomarkers of brain amyloidosis and neurodegeneration/synaptic dysfunction are featured in recent diagnostic criteria for Alzheimer's disease. Several gaps in our knowledge, however, need to be filled before they can be adopted clinically. The aim of this article is to describe a roadmap, developed by a multidisciplinary task force, to rationally implement biomarkers for Italian Memory Clinics. This roadmap is based on a framework comprising 5 sequential phases: identification of leads for potentially useful biomarkers; development of clinical assays for clinical disease; evaluation of detection of early stages; definition of operating characteristics in relevant populations; and estimation of reducing disease-associated mortality, morbidity, and disability. The roadmap was devised by identifying current evidence of validity, still missing evidence, and action needed to collect this missing evidence. With appropriate adaptation to local, country-specific circumstances, the roadmap can be translated to other countries.


Alzheimer; Biomarkers; Diagnosis; Validation

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