Additional investigations, such as a cranial magnetic resonance imaging (MRI) scan, 18fluorine-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET), cerebrospinal fluid (CSF) examination, and AD biomarkers (β-amyloid42 [Aβ42], total tau protein [t-tau], and tau phosphorylated at

position threonine 181 [p-tau]), may Inhibitors,research,lifescience,medical further help to establish the correct diagnosis. A typical clinical picture for AD consists of a slowly progressive memory loss and loss of other neuropsychological functions (eg, praxis, speech), absence of medical, neurological, or psychiatric condition that may explain the memory loss, brain imaging that is in line with AD, and biomarkers supporting the diagnosis Inhibitors,research,lifescience,medical of AD.5 Atypical symptoms such as early neurological symptoms, mood disorder, visual hallucinations, or an atypical sudden onset may hint at a diagnosis other than AD. Comprehensive information on the clinical diagnosis and management of the most important dementing diseases other than AD (eg, vascular cognitive impairment, frontotemporal dementia (FTD), Lewy body dementia (LBD), corticobasal syndrome, progressive supranuclear palsy, Parkinson’s disease-related dementia, Huntington’s disease, prion diseases, normal-pressure hydrocephalus, limbic Apoptosis inhibitor encephalitis and other toxic and metabolic disorders) is provided Inhibitors,research,lifescience,medical in the recent EFNS-ENS guidelines (European

Federation of Neurological societies-European Neurological Society).6 Inhibitors,research,lifescience,medical For the first time, the recently released revised diagnostic criteria for AD involve biomarkers to support the diagnosis of AD: (i) reduced

CSF Aβ42; (ii) raised CSF tau (t-tau and p-tau); (iii) positive PET amyloid imaging; (iv) typical patterns in 18F-FDG-PET; and Inhibitors,research,lifescience,medical (v) disproportionate atrophy involving medial, basal, and lateral temporal lobes and medial and lateral parietal cortices.5,7-9 If available, these biomarkers may be helpful in the distinction between AD and non-AD memory impairment. However, some alterations and biomarker constellations thought to be typical for AD may also be found in other neurodegenerative disorders, possibly hampering the discrimination between AD and non-AD etiology of memory impairment. For example, CSF Aβ42 values have been found to be decreased in AD as well as in LED patients,10 and CNS amyloid accumulation can be observed in patients Levetiracetam with AD and LED using amyloid imaging.11 Hippocampal atrophy, as seen in many AD patients, is also found in patients with frontotemporal dementia (FTD), possibly due to hippocampal sclerosis related to this disease.12 Neuropsychological testing During the diagnostic process for memory complaints, it is essential to objectively assess memory impairment, and the impact on activities of daily living, in order to discriminate between subjective memory impairment (SMI), mild cognitive impairment (MCI), and dementia (mild, moderate, or severe).