Lesson 1Definitions and current diagnostic criteria (NIA-AA 2011/2018 research framework, IWG)It sums up the main diagnostic standards for Alzheimer’s disease, like NIA-AA 2011, NIA-AA 2018 research framework, and IWG criteria. It points out changes towards biological definitions and what that means for clinic work versus research.
Core elements of NIA-AA 2011 clinical criteriaNIA-AA 2018 biological definition and AT(N) useKey features of IWG diagnostic criteriaDifferences between clinical and research criteriaImplications for trial enrollment and labelingLesson 2When and how to combine biomarkers (CSF, blood, PET, MRI) to increase diagnostic certaintyIt looks at ways to mix CSF, blood, structural MRI, and PET markers to boost confidence in diagnosis. It talks about matching and mismatching patterns, ordering tests, and combining results with clinical signs and disease stage.
Principles of multimodal biomarker integrationCommon concordant and discordant result patternsSequential versus parallel testing strategiesAligning biomarker choice with disease stageCommunicating combined results to patientsLesson 3Molecular neuroimaging: amyloid PET and tau PET — indications, reading, quantitation, and regional patternsIt focuses on amyloid and tau PET scans, including when to use them, reasons not to, and how to read them. It covers regional uptake patterns, measurement tools, common mistakes, and how PET results affect diagnosis and care plans.
Appropriate use criteria for amyloid PETTypical amyloid PET regional uptake patternsTau PET tracers and distribution in Alzheimer’sVisual reads versus quantitative PET measuresCommon artifacts and interpretive pitfallsLesson 4Structural and functional imaging: MRI (atrophy patterns, volumetry), FDG-PET — differential diagnostic utilityIt explains structural MRI and FDG-PET findings in Alzheimer’s disease and other similar conditions. It reviews typical atrophy and low metabolism patterns, measurement tools, and how scans support or question a suspected diagnosis.
Medial temporal and parietal atrophy patternsVisual rating scales and volumetric quantificationFDG-PET hypometabolism in Alzheimer’s diseaseImaging clues to non-Alzheimer’s dementiasIntegrating MRI and FDG-PET with clinical dataLesson 5Practical algorithms for ordering tests given cost, availability, and patient comorbidity constraintsIt gives step-by-step ways to pick biomarker tests considering cost, access, and patient health issues. It stresses matching strategies to the clinical need, healthcare setup, and patient wishes while skipping unnecessary tests.
Initial cognitive workup before biomarker testingChoosing CSF versus blood biomarkersWhen to add amyloid or tau PET imagingAdapting algorithms to comorbidities and frailtyCost, insurance coverage, and health system limitsLesson 6Established fluid biomarkers: CSF Aβ42/40, total tau, phosphorylated tau assays — interpretation and limitationsIt details known CSF markers like Aβ42, Aβ42/40 ratio, total tau, and phosphorylated tau. It explains test methods, cut-off points, typical Alzheimer’s patterns, plus test variations, unclear zones, and other causes of odd results.
CSF Aβ42 and Aβ42/40 ratio: biology and cutoffsTotal tau as a marker of neuronal injuryPhosphorylated tau isoforms and assay platformsInterpreting discordant or borderline CSF profilesNon-Alzheimer’s conditions affecting CSF markersLesson 7Blood-based biomarkers: plasma p-tau (181, 217), Aβ42/40, neurofilament light (NfL) — validity, thresholds, and preanalytical issuesIt covers blood markers including plasma p-tau181, p-tau217, Aβ42/40, and neurofilament light. It discusses test reliability, cut-off points, sample handling, and how blood tests stack up against CSF and PET in various settings.
Biology and kinetics of plasma p-tau isoformsPlasma Aβ42/40 ratio and assay approachesNeurofilament light as a nonspecific injury markerPreanalytical factors affecting plasma biomarkersClinical scenarios suited to blood-based testingLesson 8Clinical phenotypes of Alzheimer’s disease and typical progression patternsIt describes common and unusual clinical types of Alzheimer’s disease, like memory loss type, posterior cortical, logopenic, and frontal types. It reviews progression paths, daily function loss, and how type links to marker profiles.
Typical amnestic late-onset Alzheimer’s presentationPosterior cortical atrophy and visuospatial deficitsLogopenic variant primary progressive aphasiaFrontal and behavioral-predominant Alzheimer’sLongitudinal progression and functional milestonesLesson 9Biomarker-based staging (AT(N) framework) and linking biomarkers to clinical stageIt introduces staging using markers with the AT(N) framework, connecting amyloid, tau, and nerve damage markers to clinical stage. It covers staging plans, usual paths, and how AT(N) helps with outlook and trial entry.
Conceptual basis of the AT(N) classificationMapping AT(N) profiles to clinical stagesLongitudinal change in AT(N) over the disease courseUsing AT(N) for prognosis and risk communicationLimitations and controversies of AT(N) stagingLesson 10Preanalytical, laboratory quality, and regulatory considerations for biomarker testingIt reviews sample handling, test checking, and quality systems for Alzheimer’s markers. It covers approvals, rules, and reporting standards to make sure test results are reliable and useful in clinics across labs.
Sample collection tubes and timing requirementsCentrifugation, aliquoting, and storage conditionsInternal quality control and external proficiency testingRegulatory approval pathways and labeling limitsStandardized reporting formats and reference ranges
