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van Maurik IS, Vos SJ, Bos I, Bouwman FH, Teunissen CE, Scheltens P, Barkhof F, Frolich L, Kornhuber J, Wiltfang J, Maier W, Peters O, Rüther E, Nobili F, Frisoni GB, Spiru L, Freund-Levi Y, Wallin AK, Hampel H, Soininen H, Tsolaki M, Verhey F, Kłoszewska I, Mecocci P, Vellas B, Lovestone S, Galluzzi S, Herukka SK, Santana I, Baldeiras I, de Mendonça A, Silva D, Chetelat G, Egret S, Palmqvist S, Hansson O, Visser PJ, Berkhof J, van der Flier WM. Biomarker-based prognosis for people with mild cognitive impairment (ABIDE): a modelling study. Lancet Neurol 2019; 18:1034-1044. [PMID: 31526625 DOI: 10.1016/s1474-4422(19)30283-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/02/2019] [Accepted: 07/09/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Biomarker-based risk predictions of dementia in people with mild cognitive impairment are highly relevant for care planning and to select patients for treatment when disease-modifying drugs become available. We aimed to establish robust prediction models of disease progression in people at risk of dementia. METHODS In this modelling study, we included people with mild cognitive impairment (MCI) from single-centre and multicentre cohorts in Europe and North America: the European Medical Information Framework for Alzheimer's Disease (EMIF-AD; n=883), Alzheimer's Disease Neuroimaging Initiative (ADNI; n=829), Amsterdam Dementia Cohort (ADC; n=666), and the Swedish BioFINDER study (n=233). Inclusion criteria were a baseline diagnosis of MCI, at least 6 months of follow-up, and availability of a baseline Mini-Mental State Examination (MMSE) and MRI or CSF biomarker assessment. The primary endpoint was clinical progression to any type of dementia. We evaluated performance of previously developed risk prediction models-a demographics model, a hippocampal volume model, and a CSF biomarkers model-by evaluating them across cohorts, incorporating different biomarker measurement methods, and determining prognostic performance with Harrell's C statistic. We then updated the models by re-estimating parameters with and without centre-specific effects and evaluated model calibration by comparing observed and expected survival. Finally, we constructed a model combining markers for amyloid deposition, tauopathy, and neurodegeneration (ATN), in accordance with the National Institute on Aging and Alzheimer's Association research framework. FINDINGS We included all 2611 individuals with MCI in the four cohorts, 1007 (39%) of whom progressed to dementia. The validated demographics model (Harrell's C 0·62, 95% CI 0·59-0·65), validated hippocampal volume model (0·67, 0·62-0·72), and updated CSF biomarkers model (0·72, 0·68-0·74) had adequate prognostic performance across cohorts and were well calibrated. The newly constructed ATN model had the highest performance (0·74, 0·71-0·76). INTERPRETATION We generated risk models that are robust across cohorts, which adds to their potential clinical applicability. The models could aid clinicians in the interpretation of CSF biomarker and hippocampal volume results in individuals with MCI, and help research and clinical settings to prepare for a future of precision medicine in Alzheimer's disease. Future research should focus on the clinical utility of the models, particularly if their use affects participants' understanding, emotional wellbeing, and behaviour. FUNDING ZonMW-Memorabel.
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Affiliation(s)
- Ingrid S van Maurik
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.
| | - Stephanie J Vos
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, Netherlands
| | - Isabelle Bos
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, Netherlands
| | - Femke H Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Lutz Frolich
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, Medical Faculty Mannheim University of Heidelberg, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August-University, Göttingen, Germany; German Center for Neurodegenerative Diseases, Göttingen, Germany; iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Gerotopsychiatry, University of Bonn, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Flavio Nobili
- Clinical Neurology, Department of Neurosciences, University of Genoa, Genoa, Italy; Neurology Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni B Frisoni
- Memory Clinic, University Hospital and University of Geneva, Geneva, Switzerland
| | - Luiza Spiru
- Geriatrics, Gerontology and Old Age Psychiatry Clinical Department, Carol Davila University of Medicine and Pharmacy-"Elias" Emergency Clinical Hospital, Bucharest, Romania; Memory Clinic and Longevity Medicine, Ana Aslan International Foundation, Romania
| | - Yvonne Freund-Levi
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden; Department of Old Age Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Asa K Wallin
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Harald Hampel
- Alzheimer Precision Medicine, GRC 21, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Eisai, Neurology Business Group, Woodcliff Lake, NJ, USA
| | - Hilkka Soininen
- Institute of Clinical Medicine, Neurology, University of Eastern Finland and Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Magda Tsolaki
- 1st Department of Neurology, Aristotle University of Thessaloniki, Memory and Dementia Center, "AHEPA" General Hospital, Thessaloniki, Greece
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, Netherlands
| | - Iwona Kłoszewska
- Department of Geriatric Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | | | | | - Samantha Galluzzi
- Lab Alzheimer's Neuroimaging and Epidemiology, IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sanna-Kaisa Herukka
- Institute of Clinical Medicine, Neurology, University of Eastern Finland and Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Isabel Santana
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ines Baldeiras
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | | - Dina Silva
- Institute of Molecular Medicine, University of Lisbon, Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Centre for Biomedical Research, Universidade do Algarve, Faro, Portugal
| | - Gael Chetelat
- Université Normandie, Inserm, Université de Caen-Normandie, Inserm UMR-S U1237, GIP Cyceron, Caen, France
| | - Stephanie Egret
- Université Normandie, Inserm, Université de Caen-Normandie, Inserm UMR-S U1237, GIP Cyceron, Caen, France
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden; Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, Netherlands
| | - Johannes Berkhof
- Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
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Lleó A, Alcolea D, Martínez-Lage P, Scheltens P, Parnetti L, Poirier J, Simonsen AH, Verbeek MM, Rosa-Neto P, Slot RER, Tainta M, Izaguirre A, Reijs BLR, Farotti L, Tsolaki M, Vandenbergue R, Freund-Levi Y, Verhey FRJ, Clarimón J, Fortea J, Frolich L, Santana I, Molinuevo JL, Lehmann S, Visser PJ, Teunissen CE, Zetterberg H, Blennow K. Longitudinal cerebrospinal fluid biomarker trajectories along the Alzheimer's disease continuum in the BIOMARKAPD study. Alzheimers Dement 2019; 15:742-753. [PMID: 30967340 DOI: 10.1016/j.jalz.2019.01.015] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/29/2018] [Accepted: 01/21/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Within-person trajectories of cerebrospinal fluid (CSF) biomarkers in Alzheimer's disease (AD) are not well defined. METHODS We included 467 subjects from the BIOMARKAPD study with at least two serial CSF samples. Diagnoses were subjective cognitive decline (n = 75), mild cognitive impairment (n = 128), and AD dementia (n = 110), and a group of cognitively unimpaired subjects (n = 154) were also included. We measured baseline and follow-up CSF levels of total tau (t-tau), phosphorylated tau (p-tau), YKL-40, and neurofilament light (NfL). Median CSF sampling interval was 2.1 years. RESULTS CSF levels of t-tau, p-tau, NfL, and YKL-40 were 2% higher per each year of baseline age in controls (P <.001). In AD, t-tau levels were 1% lower (P <.001) and p-tau levels did not change per each year of baseline age. Longitudinally, only NfL (P <.001) and YKL-40 (P <.02) increased during the study period. DISCUSSION All four CSF biomarkers increase with age, but this effect deviates in AD for t-tau and p-tau.
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Affiliation(s)
- Alberto Lleó
- Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain.
| | - Daniel Alcolea
- Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Pablo Martínez-Lage
- Center for Research and Advanced Therapies, Fundación CITA-alzheimer Fundazioa, San Sebastian, Spain
| | - Philip Scheltens
- Amsterdam UMC, Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Lucilla Parnetti
- Centre for Memory Disturbances, Section of Neurology, Lab of Clinical Neurochemistry, University of Perugia, Perugia, Italy
| | - Judes Poirier
- Centre for the Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montréal, QC, Canada
| | - Anja H Simonsen
- Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Marcel M Verbeek
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, the Netherlands; Department of Laboratory Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, the Netherlands
| | - Pedro Rosa-Neto
- Centre for the Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montréal, QC, Canada
| | - Rosalinde E R Slot
- Amsterdam UMC, Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Mikel Tainta
- Center for Research and Advanced Therapies, Fundación CITA-alzheimer Fundazioa, San Sebastian, Spain
| | - Andrea Izaguirre
- Center for Research and Advanced Therapies, Fundación CITA-alzheimer Fundazioa, San Sebastian, Spain
| | - Babette L R Reijs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Lucia Farotti
- Centre for Memory Disturbances, Section of Neurology, Lab of Clinical Neurochemistry, University of Perugia, Perugia, Italy
| | - Magda Tsolaki
- 1st Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Makedonia, Greece; Alzheimer Hellas, Thessaloniki, Greece
| | - Rik Vandenbergue
- University Hospital Leuven, Leuven, Belgium; Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Yvonne Freund-Levi
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Center for Alzheimer Research, Division of Clinical Geriatrics, Huddinge and Department of Old Age Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Jordi Clarimón
- Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Juan Fortea
- Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Lutz Frolich
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Isabel Santana
- Dementia Clinic, Centro Hospitalar e Universitário de Coimbra and Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal
| | | | | | - Pieter J Visser
- Amsterdam UMC, Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Charlotte E Teunissen
- Amsterdam UMC, Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, University College London, Queen Square, London, United Kingdom; UK Dementia Research Institute at UCL, London, United Kingdom
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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3
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Hall A, Mattila J, Koikkalainen J, Lotjonen J, Wolz R, Scheltens P, Frisoni G, Tsolaki M, Nobili F, Freund-Levi Y, Minthon L, Frolich L, Hampel H, Visser P, Soininen H. Predicting Progression from Cognitive Impairment to Alzheimer’s Disease with the Disease State Index. Curr Alzheimer Res 2015; 12:69-79. [PMID: 25523428 DOI: 10.2174/1567205012666141218123829] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 11/28/2014] [Accepted: 12/04/2014] [Indexed: 11/22/2022]
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Hausner L, Kromer R, Beutelspacher S, Serbic N, Frolich L. P1–126: Detection of retinal nerve fibre layer defects in Alzheimer's dementia using SD‐OCT. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Robert Kromer
- Medical Faculty Mannheim Ruprecht‐Karls‐University Heidelberg Mannheim Germany
| | - Sven Beutelspacher
- Medical Faculty Mannheim Ruprecht‐Karls‐University Heidelberg Mannheim Germany
| | | | - Lutz Frolich
- Central Institute of Mental Health, Medical Faculty Mannheim Ruprecht‐Karls‐University Heidelberg Mannheim Germany
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Peters O, Joachim LK, Schmidtke K, Hüll M, Rüther E, Teipel S, Möller H, Jessen F, Luckhaus C, Maier W, Wiltfang J, Kornhuber J, Frolich L, Heuser I. P2‐013: CSF biomarkers and disease progression in an interrupted MCI trial. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | | | | | - Stefan Teipel
- Department of PsychiatryUniversity of RostockRostockGermany
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Frolich L, Monsch A, Kressig R, Downs P, Caputo A, Strohmaier C. P3‐422: Comparisons of patient characteristics in subpopulations of the OPtimising Transdermal Exelon In Mild‐to‐moderate Alzheimer's disease (OPTIMA) study. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.2096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Lutz Frolich
- Department of Geriatric PsychiatryCentral Institute of Mental HealthMannheimGermany
| | | | | | - Pamela Downs
- Novartis Pharmaceuticals CorporationsEast HanoverNew JerseyUnited States
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Cummings J, Frolich L, Black S, Bakchine S, Bellelli G, Molinuevo J, Kressig R, Downs P, Caputo A, Strohmaier C. Managing Functional and Cognitive Decline in Patients with Mild-to-Moderate Alzheimer's Disease: A 48-Week, Randomized, Double-Blind Evaluation of 13.3 mg/24 h (15 cm{superscript 2}) Versus 9.5 mg/24 h (10 cm{superscript 2}) Rivastigmine Patch (P04.193). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Wagner M, Wolf S, Reischies FM, Daerr M, Wolfsgruber S, Jessen F, Popp J, Maier W, Hull M, Frolich L, Hampel H, Perneczky R, Peters O, Jahn H, Luckhaus C, Gertz HJ, Schroder J, Pantel J, Lewczuk P, Kornhuber J, Wiltfang J. Biomarker validation of a cued recall memory deficit in prodromal Alzheimer disease. Neurology 2012; 78:379-86. [DOI: 10.1212/wnl.0b013e318245f447] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Frings L, Kloppel S, Teipel S, Peters O, Frolich L, Pantel J, Schroder J, Gertz HJ, Arlt S, Heuser I, Kornhuber J, Wiltfang J, Maier W, Jessen F, Hampel H, Hull M. Left Anterior Temporal Lobe Sustains Naming in Alzheimers Dementia and Mild Cognitive Impairment. Curr Alzheimer Res 2011; 8:893-901. [DOI: 10.2174/156720511798192673] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 04/01/2011] [Accepted: 04/05/2011] [Indexed: 11/22/2022]
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Vos S, Verhey F, Scheltens P, Soininen H, Wahlund L, Hampel H, Tsolaki M, Minthon L, Frisoni G, Frolich L, Nobili F, Van der Flier W, Blennow K, Wolz R, Visser PJ. P3‐108: CSF, MRI, and APOE biomarkers as predictors for Alzheimer‐type dementia in subjects with amnestic versus non‐amnestic mild cognitive impairment. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | | | | | | | | | | | - Magda Tsolaki
- Aristotle University of ThessalonikiThessalonikiGreece
| | | | | | | | | | | | | | - Robin Wolz
- Imperial College LondonLondonUnited Kingdom
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Rossum I, Soininen H, Frolich L, Visser PJ, Scheltens P, Blennow K, Verhey FR, Frisoni G, Hampel H, Wahlund L, Wolz R, Van der Flier W, Tsolaki M, Nobili F, Minthon L. O1‐06‐06: Predictive accuracy for Alzheimer's Disease of CSF Aß1‐42, hippocampal atrophy and APOE genotype in MCI subjects depends on age. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ineke Rossum
- Alzheimer CenterVU University Medical CenterAmsterdamThe Netherlands
| | | | - Lutz Frolich
- Zentralinstitut für Seelische GesundheitUniversity of HeidelbergMannheim
| | | | | | - Kaj Blennow
- Göteborg University, Sahlgrenska University HospitalMölndal
| | - Frans R.J. Verhey
- Alzheimer CentreSchool for Mental Health and Neuroscience (MHeNS), University Medical CentreMaastricht
| | | | | | | | | | | | - Magda Tsolaki
- Aristotle University of Thessaloniki, Memory and Dementia CenterThessaloniki
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Abstract
Given the important role that physicians play in clinical care, disease advocacy, national health policy making and clinical research, the IMPACT survey sought to assess the attitudes and perceptions of physicians in 3 general categories: diagnosis and treatment of Alzheimer's disease (AD); caregivers and families of patients with AD; and the role of government in dealing with this disease and its consequences. Survey respondents comprised a total of 250 generalists and 250 specialists (neurologists, geriatricians, neuro-psychiatrists, psychiatrists and psychogeriatricians) from France, Germany, Italy, Spain and the United Kingdom. Physicians were aged 25 to 69 years, in practice for between 5 and 30 years and currently spending more than 50% of their time in direct patient care. Results showed that a sizable majority of physicians throughout Europe, specialists and generalists alike, agree that: 1) AD is underdiagnosed and undertreated; 2) patients and families are not prepared to recognise the early symptoms of the disease; 3) early treatment can help to slow the progression of the disease; and 4) more effective treatments are needed. Attitudes were statistically significantly different between some groups of physicians regarding disclosure of the diagnosis of AD, the benefits of lifestyle modification, and the value of AD-specific medication in patients whose symptoms are worsening. Differences in attitudes and perceptions of AD between specialists and generalists were limited; differences between countries were more common and of greater magnitude, particularly with respect to barriers to the use of prescription medications.
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Affiliation(s)
- P Martinez-Lage
- Fundació ACE-Institut Català de Neurociéncies Aplicades, Barcelona, Spain.
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Frolich L. F1‐02‐04: Predictors for progression to Alzheimer's disease in MCI subjects: Results from the German Dementia Competence Network (DCN). Alzheimers Dement 2010. [DOI: 10.1016/j.jalz.2010.05.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lutz Frolich
- Central Institute for Mental HealthMannheim Germany
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Tsolaki M, Papaliagkas V, Anogianakis G, Bernabei R, Emre M, Frolich L, Visser PJ, Michel JP, Pirttila T, Olde Rikkert M, Soininen H, Sobow T, Vellas B, Verhey F, Winblad B. Consensus statement on dementia education and training in Europe. J Nutr Health Aging 2010; 14:131-5. [PMID: 20126961 DOI: 10.1007/s12603-009-0238-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The aim of the current statement is to agree on: (1) what is the current situation with education and training on dementia in Europe; (2) what are the minimum educational requirements for professionals (neurologists, psychiatrists, primary care providers, nurses, biologists, neuroradiologists, etc.) regarding Alzheimer's disease and dementia, and (3) how to start a course of action for the future. DESIGN In 2005, a simple questionnaire was sent to members of the European Alzheimer's Disease Consortium (EADC) concerning the education and training on dementia in their countries. Fourteen universities of the respective countries responded to this simple questionnaire. The answers varied, and the conclusion of this effort was that little was done concerning the training of students and health professionals on dementia. In 2008, another more structured and specified questionnaire was sent to professors in different universities of the same countries. RESULTS The answers obtained were different from those of the previous questionnaire and demonstrated that it is very difficult to know about training and education in the field of dementia in every European country. CONCLUSION From the data collected, it seems that although in the recent past little had been done concerning training on dementia, nowadays training has been developed in most European countries, and relevant educational projects exist both for medical students and doctors during their specialty training. Our main purpose is to develop training material or develop specific courses to improve the professional knowledge about dementia so that best medical and non-medical practice is implemented.
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MESH Headings
- Curriculum
- Dementia/diagnosis
- Dementia/therapy
- Education, Medical/standards
- Education, Medical/statistics & numerical data
- Education, Medical/trends
- Education, Medical, Continuing/standards
- Education, Medical, Continuing/statistics & numerical data
- Education, Medical, Continuing/trends
- Education, Medical, Graduate/standards
- Education, Medical, Graduate/statistics & numerical data
- Education, Medical, Graduate/trends
- Europe
- Guidelines as Topic
- Health Knowledge, Attitudes, Practice
- Humans
- Interdisciplinary Communication
- Patient Care Team
- Students, Dental
- Surveys and Questionnaires
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Affiliation(s)
- M Tsolaki
- 3rd Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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15
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Kornhuber J, Schmidtke K, Frolich L, Perneczky R, Wolf S, Hampel H, Jessen F, Heuser I, Peters O, Weih M, Jahn H, Luckhaus C, Hüll M, Gertz HJ, Schröder J, Pantel J, Rienhoff O, Seuchter SA, Rüther E, Henn F, Maier W, Wiltfang J. Early and differential diagnosis of dementia and mild cognitive impairment: design and cohort baseline characteristics of the German Dementia Competence Network. Dement Geriatr Cogn Disord 2009; 27:404-17. [PMID: 19339779 DOI: 10.1159/000210388] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The German Dementia Competence Network (DCN) has established procedures for standardized multicenter acquisition of clinical, biological and imaging data, for centralized data management, and for the evaluation of new treatments. METHODS A longitudinal cohort study was set up for patients with mild cognitive impairment (MCI), patients with mild dementia and control subjects. The aims were to establish the diagnostic, differential diagnostic and prognostic power of a range of clinical, laboratory and imaging methods. Furthermore, 2 clinical trials were conducted with patients suffering from MCI and mild to moderate Alzheimer's Disease (AD). These trials aimed at evaluating the efficacy and safety of the combination of galantamine and memantine versus galantamine alone. RESULTS Here, we report on the scope and projects of the DCN, the methods that were employed, the composition and flow within the diverse groups of patients and control persons and on the clinical and neuropsychological baseline characteristics of the group of 2,113 subjects who participated in the observational and clinical trials. CONCLUSION These data have an impact on the procedures for the early and differential clinical diagnosis of dementias, the current standard treatment of AD as well as on future clinical trials in AD.
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Affiliation(s)
- Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Erlangen, Erlangen, Germany.
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16
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Winblad B, Frisoni GB, Frolich L, Johannsen P, Johansson G, Kehoe P, Lovestone S, Olde-Rikkert M, Reynish E, Visser PJ, Vellas B. Editorial: EADC (European Alzheimer Disease Consortium) recommendations for future Alzheimer disease research in Europe. J Nutr Health Aging 2008; 12:683-4. [PMID: 19043641 DOI: 10.1007/bf03028614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Visser PJ, Verhey FRJ, Boada M, Bullock R, De Deyn PP, Frisoni GB, Frolich L, Hampel H, Jolles J, Jones R, Minthon L, Nobili F, Olde Rikkert M, Ousset PJ, Rigaud AS, Scheltens P, Soininen H, Spiru L, Touchon J, Tsolaki M, Vellas B, Wahlund LO, Wilcock G, Winblad B. Development of screening guidelines and clinical criteria for predementia Alzheimer's disease. The DESCRIPA Study. Neuroepidemiology 2008; 30:254-65. [PMID: 18515975 DOI: 10.1159/000135644] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 03/02/2008] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND There is an urgent need to identify subjects with Alzheimer's disease (AD) in the predementia phase, but validated diagnostic approaches are currently lacking. In this paper, we present the background, design and methods of a study, which aims to develop clinical criteria for predementia AD. We also present baseline characteristics of the subjects included. The study was part of the multicentre DESCRIPA project, which is being conducted within the network of the European Alzheimer's Disease Consortium. METHODS Clinical criteria will be based on a prospective cohort study of non-demented subjects older than 55 years and referred to a memory clinic. At baseline, a number of markers and risk factors for AD were collected, including demographic variables, measures of performance in activities of daily living, cognitive, neuroimaging and genetic markers, and serum and cerebrospinal fluid markers. Subjects will be reassessed annually for 2-3 years, and we will evaluate which combination of variables best predicts AD-type dementia at follow-up. RESULTS Between 2003 and 2005, 881 subjects were included from 20 memory clinics. Subjects were on average 70.3 years old, and had 10.4 years of education. The average score on the Mini-Mental State Examination was 27.4.
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Affiliation(s)
- P J Visser
- Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands.
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18
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Frolich L. Outcomes for clinical trials in mild-to-moderate dementia to evaluate drugs with presumably symptomatic effects. J Nutr Health Aging 2007; 11:357-8. [PMID: 17653499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- L Frolich
- L. Frolich, Division of Geriatric Psychiatry, Central Institute for Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
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19
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Geldmacher DS, Frolich L, Doody RS, Erkinjuntti T, Vellas B, Jones RW, Banerjee S, Lin P, Sano M. Realistic expectations for treatment success in Alzheimer's disease. J Nutr Health Aging 2006; 10:417-29. [PMID: 17066215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Alzheimer's disease (AD) is a progressive degenerative disease that warrants active management to delay or slow progression of its symptoms. The symptoms of AD encompass behavior and daily function as well as cognition, so clinicians should take a global view in the assessment of treatment success. Because there is currently no cure for AD, one cannot expect an initial cognitive improvement observed in the first few months of therapy to be sustained indefinitely. However, one should expect that the patient who is treated early and persistently with medication for AD will show less evidence of behavioral, functional, and cognitive deterioration over a period of time than one would expect in the absence of pharmacotherapy. Thus, treatment success includes not only short-term improvement of symptoms but also less decline over the long term. Determination of treatment success therefore also requires awareness of the typical progression of untreated AD. In this article we review the natural history of AD and evidence for the effectiveness of the treatments indicated for AD: donepezil, galantamine, rivastigmine, and memantine.
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Affiliation(s)
- D S Geldmacher
- Memory Disorders Program, Department of Neurology, University of Virginia, Box 800394, Charlottesville, Virginia 22908, USA
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Frolich L, Berger G. P4–214: The influence of cognitive and behavioral symptoms on caregiver burden and depression over time in mild to moderate dementia. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.1954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Lutz Frolich
- Central Institute for Mental HealthMannheimGermany
| | - Gabriele Berger
- Department of PsychiatryUniversity of FrankfurtFrankfurt/MainGermany
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Berger G, Bernhardt T, Weimer E, Peters J, Kratzsch T, Frolich L. Longitudinal study on the relationship between symptomatology of dementia and levels of subjective burden and depression among family caregivers in memory clinic patients. J Geriatr Psychiatry Neurol 2005; 18:119-28. [PMID: 16100100 DOI: 10.1177/0891988704273375] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The objective was to evaluate the course and severity of dementia-related symptoms and their relationship to caregivers' subjective burden and depression over time. Forty-five patients with dementia and their caregivers were followed over a period of 2 years. Patients' cognition, function, and behavioral/psychological symptoms were assessed by the Mini Mental State Examination, Syndrome Kurz Test, Geriatric Depression Screening scale, Instrumental Activities of Daily Living Scale, Physical Self Maintenance Scale, Behavioral Abnormalities in Alzheimer's Disease Rating Scale, and Nurses Observation Scale for Geriatric Patients. Caregivers' depression and subjective burden were evaluated by the Geriatric Depression Screening scale or Beck Depression Inventory and the Caregiver Burden Interview. Global dementia severity, functional impairment, and behavioral disturbances increased significantly over the 2-year observation period. Caregivers' burden remained stable, and severe depression decreased over time. There were significant associations between burden and dementia-related symptoms. For deficits in activities of daily living as well as behavioral disturbances, these associations became stronger over time. It was concluded that stage of dementia, functional deficits, and behavioral disturbances are important factors when evaluating the relationship between patients' symptoms and caregivers' well-being.
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Affiliation(s)
- Gabriele Berger
- Department of Psychiatry and Psychotherapy, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
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Berger G, Bernhardt T, Schramm U, Müller R, Landsiedel-Anders S, Peters J, Kratzsch T, Frolich L. No effects of a combination of caregivers support group and memory training/music therapy in dementia patients from a memory clinic population. Int J Geriatr Psychiatry 2004; 19:223-31. [PMID: 15027037 DOI: 10.1002/gps.1055] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To evaluate the impact of a combination of caregiver support group and memory training/music therapy in dementia patients on behavioural and psychological symptoms (BPSD) and caregiver burden compared to a control group. METHOD Eighteen patient-carer-dyads in the treatment group and 18 patient-carer-dyads as controls were studied in the setting of a memory clinic of a psychiatric university hospital over a period of 2 years. Controls were matched for age, gender, diagnosis, dementia severity, living arrangement and medication. The interventions were conducted once per week for 1 hour run by a clinical psychogeriatric team. Outcome measures were patients' cognitive and functional status as well as BPSD and caregivers subjective burden and depression measured by validated scales. Data were obtained 6, 12 and 24 months after baseline. RESULTS There were no significant differences between the intervention and control group neither after 6, 12 nor after 24 months treatment. CONCLUSIONS The lack of a positive impact in alleviating caregiver burden or BPSD after intensive psychological interventions may result from extensive care in the routine clinical management including individual counselling for patients and families. The effect of 'treatment as usual' needs to be taken into account when comparing an intervention and control group, as well as the dosage of the intervention.
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Affiliation(s)
- Gabriele Berger
- Department of Psychiatry and Psychotherapy, JW Goethe University, Frankfurt/Main, Germany
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Peters J, Kratzsch T, Ruth M, Berger G, Schramm U, Frolich L. Combination of mini-mental-state-exam and clock drawing test leads to an enhanced sensitivity in screening for dementia. Neurobiol Aging 2000. [DOI: 10.1016/s0197-4580(00)83402-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kratzsch T, Peters J, Seidler A, Tanja B, Frolich L. Predictive factors for the utilization of a memory clinic. Neurobiol Aging 2000. [DOI: 10.1016/s0197-4580(00)83450-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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25
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Calabrese P, Berger F, Sramko CA, Frolich L. An evaluation of donepezil in Alzheimer's disease: Results from a post marketing surveillance study in Germany. Neurobiol Aging 2000. [DOI: 10.1016/s0197-4580(00)83196-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hashimoto E, Frolich L, Ozawa H, Saito T, Shichinohe S, Takahata N, Riederer P. Alteration of Glutamyltranspeptidase Binding Proteins in Postmortem Brains of Heroin Addicts. Alcohol Clin Exp Res 1996. [DOI: 10.1111/j.1530-0277.1996.tb01797.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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27
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Hashimoto E, Frolich L, Ozawa H, Saito T, Shichinohe S, Takahata N, Riederer P. Alteration of Glutamyltranspeptidase Binding Proteins in Postmortem Brains of Heroin Addicts. Alcohol Clin Exp Res 1996. [DOI: 10.1111/j.1530-0277.1996.tb01162.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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