Diagnostics Dashboard

Diagnostics Dashboard

Overview

The Diagnostics Dashboard provides a quick-access overview of diagnostic methods and tools for neurodegenerative diseases including [Alzheimer's disease](/diseases/alzheimers-disease), [Parkinson's disease](/diseases/parkinsons-disease), [Multiple System Atrophy](/diseases/multiple-system-atrophy), [Progressive Supranuclear Palsy](/diseases/progressive-supranuclear-palsy), and [Corticobasal Syndrome](/diseases/corticobasal-syndrome). This page serves as a central hub for navigating biomarker assays, neuroimaging techniques, clinical assessment scales, genetic testing, and emerging diagnostic technologies. Rapid and accurate diagnosis is critical for disease-modifying therapy development, patient stratification, and clinical trial enrollment.

Quick Stats

| Metric | Value |
|--------|-------|
| Total Diagnostic Pages | 26 |
| Neuroimaging Methods | 5 |
| Biomarker Assays | 6 |
| Clinical Scales | 3 |
| Genetic Tests | 2 |

Diagnostic Frameworks

Alzheimer's Disease: AT(N) Classification

The 2018 NIA-AA research framework defines Alzheimer's disease by [biomarkers](/biomarkers) rather than clinical syndrome[@mormino2022]. The AT(N) system classifies biomarkers into three categories:

• A: Amyloid pathology (CSF Aβ42, Aβ42/40 ratio, Amyloid PET)
• T: Tau pathology (CSF p-tau181, p-tau217, Tau PET)
• (N): Neurodegeneration (CSF t-tau, MRI hippocampal atrophy, FDG-PET)

Diagnostics Dashboard

Overview

The Diagnostics Dashboard provides a quick-access overview of diagnostic methods and tools for neurodegenerative diseases including [Alzheimer's disease](/diseases/alzheimers-disease), [Parkinson's disease](/diseases/parkinsons-disease), [Multiple System Atrophy](/diseases/multiple-system-atrophy), [Progressive Supranuclear Palsy](/diseases/progressive-supranuclear-palsy), and [Corticobasal Syndrome](/diseases/corticobasal-syndrome). This page serves as a central hub for navigating biomarker assays, neuroimaging techniques, clinical assessment scales, genetic testing, and emerging diagnostic technologies. Rapid and accurate diagnosis is critical for disease-modifying therapy development, patient stratification, and clinical trial enrollment.

Quick Stats

| Metric | Value |
|--------|-------|
| Total Diagnostic Pages | 26 |
| Neuroimaging Methods | 5 |
| Biomarker Assays | 6 |
| Clinical Scales | 3 |
| Genetic Tests | 2 |

Diagnostic Frameworks

Alzheimer's Disease: AT(N) Classification

The 2018 NIA-AA research framework defines Alzheimer's disease by [biomarkers](/biomarkers) rather than clinical syndrome[@mormino2022]. The AT(N) system classifies biomarkers into three categories:

• A: Amyloid pathology (CSF Aβ42, Aβ42/40 ratio, Amyloid PET)
• T: Tau pathology (CSF p-tau181, p-tau217, Tau PET)
• (N): Neurodegeneration (CSF t-tau, MRI hippocampal atrophy, FDG-PET)

This framework enables diagnosis in the prodromal stage, before dementia onset, enabling disease-modifying intervention[@mckhann2011].

Parkinson's Disease: MDS Clinical Diagnostic Criteria

The 2015 International Parkinson and Movement Disorders Society (MDS) criteria provide the current standard for PD diagnosis[@postuma2015]:

Core clinical features:

• Bradykinesia
• At least one of: muscular rigidity, 4-6 Hz rest tremor, postural instability

• Clear and dramatic benefit from levodopa or dopamine agonist
• Presence of levodopa-induced dyskinesia
• Resting tremor of the hand
• Loss of smell or cardiac sympathetic denervation on MIBG

• Unequivocal cerebellar findings
• Downward vertical supranuclear gaze palsy
• Frontotemporal dementia within 5 years
• Strictly unilateral onset

Multiple System Atrophy: Consensus Criteria

Second consensus criteria from 2008 define probable and possible MSA[@gilman2008]:

MSA-P (parkinsonian predominant):

• Probable: Parkinsonism with poor levodopa response + autonomic failure + at least one additional feature
• Possible: Parkinsonism with at least two features (dysarthria, DAS, rigidity, gait instability)

• Probable: Cerebellar ataxia with parkinsonism or autonomic failure + at least one additional feature
• Possible: Cerebellar ataxia with at least two additional features

• Orthostatic hypotension (≥30 mmHg systolic or ≥15 mmHg diastolic)
• Urinary incontinence or retention
• Erectile dysfunction

Progressive Supranuclear Palsy: MDS Criteria

The 2017 MDS-PSP criteria define multiple variants[@seelaar2021]:

| Variant | Core Features | Typical Features |
|---------|--------------|-------------------|
| Richardson's syndrome | Vertical supranuclear gaze palsy, postural instability | Early falls, dysarthria |
| PSP-parkinsonism | Bradykinesia, rigidity | Asymmetric onset, tremor |
| PSP-pure akinesia with gait freezing | Gait freezing, start hesitation | No tremor or gaze palsy |
| PSP-cortical | Cortical dysfunction | Apraxia, alien limb |

Corticobasal Syndrome: Clinical Criteria

The Armstrong criteria (2013) provide diagnostic levels[@armstrong2013]:

Probable CBS:

• Asymmetric presentation
• Plus at least two of: rigidity, limb apraxia, dystonia, myoclonus, cortical sensory loss

• Asymmetric presentation
• Plus at least one of: rigidity, limb apraxia, dystonia, myoclonus, cortical sensory loss

Navigation by Category

Neuroimaging Methods

| Modality | Key Application | Strength |
|----------|---------------|----------|
| [MRI](/diagnostics/mri) | Structural imaging, atrophy patterns | High resolution, no radiation |
| [PET Imaging](/diagnostics/pet-imaging) | Molecular pathology | Functional, amyloid/tau detection |
| [DaT-SPECT](/diagnostics/datspect) | Dopaminergic terminal integrity | Differentiates PD from essential tremor |
| [CT](/diagnostics/ct) | Gross structural changes | Fast, widely available |
| [Diffusion Tensor Imaging](/diagnostics/diffusion-tensor-imaging-neurodegeneration) | White matter microstructural integrity | Detects early axonal damage |

MRI Techniques by Use Case:

• T1-weighted: Volumetric analysis (hippocampal, whole brain atrophy)
• T2/FLAIR: White matter hyperintensities, brainstem abnormalities
• SWI: Iron deposition (substantia nigra), microbleeds
• DTI: Tract integrity, connectivity analysis
• fMRI: Functional connectivity, resting-state networks

Fluid Biomarkers

| Biomarker Source | Key Analytes | Disease Relevance |
|-----------------|-------------|------------------|
| [CSF Biomarkers](/diagnostics/csf-biomarkers) | Aβ42, Aβ40, p-tau, t-tau, NfL, alpha-synuclein | AD, PD, MSA, ALS |
| [Blood-Based Biomarkers](/diagnostics/blood-biomarkers) | Plasma NfL, p-tau217, GFAP | Accessible, emerging |
| [NfL](/diagnostics/neurofilament-light-chain) | Neurofilament light chain | Neurodegeneration, progression |
| [Alpha-Synuclein Assays](/diagnostics/alpha-synuclein-assays) | RT-QuIC, PMCA seeding activity | Synucleinopathies |

Emerging Blood Biomarkers (2025-2026):

• p-tau217: High discriminative power for AD vs. controls (>95% AUC) [@forder2022]
• GFAP: Astrocyte activation marker, elevated in AD and FTD
• NfL: Non-specific neurodegeneration marker, elevated across diseases
• Extracellular vesicles: Cell-type-specific cargo for targeted biomarkers

Clinical Assessment Scales

| Domain | Scales | Primary Use |
|--------|--------|-------------|
| [Cognitive Scales](/diagnostics/cognitive-scales) | MMSE, MoCA, CDR, ADAS-Cog | Cognitive impairment staging |
| [Motor Scales](/diagnostics/motor-scales) | UPDRS, MDS-UPDRS, H&Y, BBS | PD motor severity |
| [Functional Assessments](/diagnostics/functional-assessments) | ADL, iADL, Schwab & England | Daily living function |
| Neuropsychiatric | NPI, GDS, BDI | Behavioral symptoms |
| Autonomic | COMPASS-31, SCHAF | Autonomic dysfunction |

Genetic Testing

| Gene | Disease | Test Type | Clinical Utility |
|------|---------|-----------|----------------|
| [APOE](/diagnostics/apoe-genotyping) | AD | SNP genotyping | Risk stratification |
| SNCA | PD, MSA | Gene dosage | Rare, high penetrance |
| LRRK2 | PD | NGS panel | 5% of PD, autosomal dominant |
| GBA | PD, DLB | Sequencing | 5-10% of PD, risk modifier |
| MAPT | PSP, CBD, FTD | NGS panel | Tauopathies |
| C9orf72 | ALS, FTD | Repeat PCR | Most common ALS gene |
| [Genetic Panels](/diagnostics/genetic-panels) | Multiple | Multi-gene panels | Comprehensive screening |

Navigation by Disease

Alzheimer's Disease

| Diagnostic Tool | Target | Status |
|----------------|--------|--------|
| [Amyloid PET](/diagnostics/amyloid-pet) (Florbetapir, Florbetaben) | Amyloid plaques | FDA-approved |
| [Tau PET](/diagnostics/tau-pet) (Flortaucipir) | Neurofibrillary tangles | FDA-approved |
| [CSF Aβ42/40 ratio](/diagnostics/csf-biomarkers) | Amyloid pathology | Widely available |
| [CSF p-tau181/217](/diagnostics/csf-biomarkers) | Tau pathology | Widely available |
| [Blood p-tau217](/biomarkers/p-tau217-alzheimers) | Tau pathology | Clinical implementation |
| [MRI hippocampal volumetry](/diagnostics/mri) | Neurodegeneration | Standard of care |
| [FDG-PET](/diagnostics/pet-imaging) | Hypometabolism | Supporting evidence |

Parkinson's Disease

| Diagnostic Tool | Target | Status |
|----------------|--------|--------|
| [DaT-SPECT](/diagnostics/datspect) (Ioflupane) | Dopamine transporter | FDA-approved |
| [Cardiac MIBG](/biomarkers/cardiac-mibg-scintigraphy) | Sympathetic denervation | Clinical use |
| [Alpha-Synuclein RT-QuIC](/diagnostics/alpha-synuclein-rt-quic) | Seed amplification | FDA-approved |
| [MRI neuromelanin](/diagnostics/mri) | Nigral integrity | Research |
| [Transcranial sonography](/diagnostics/transcranial-sonography) | Substantia nigra echogenicity | Research |

ALS and FTD

| Diagnostic Tool | Target | Status |
|----------------|--------|--------|
| [Neurofilament Testing](/diagnostics/neurofilament-light-chain) (NfL, pNfH) | Neurodegeneration | Standard of care |
| [Genetic Panels](/diagnostics/genetic-panels) (C9orf72, SOD1, FUS, TARDBP) | Genetic cause | Widely available |
| [EMG/ Nerve Conduction](/diagnostics/electromyography-nerve-conduction-studies) | Lower motor neuron | Standard of care |
| [Transcranial Magnetic Stimulation](/diagnostics/transcranial-magnetic-stimulation) | Upper motor neuron | Research |

Emerging Technologies

AI-Enhanced Diagnostics

Machine learning and deep learning approaches applied to neuroimaging and clinical data:

• Deep learning on MRI: Automated AD classification (AUC 0.95+)
• Radiomics: Extract quantitative features from images beyond human perception
• Clinical prediction models: Combine multimodal data for risk stratification

Digital Biomarkers

Objective, continuous measurement through smartphone and wearable sensors:

• Gait analysis: Step detection, gait variability, freezing of gait
• Tremor quantification: Frequency, amplitude, medication response
• Speech analysis: Prosody, phonation, word-finding pauses
• Ocular tracking: Saccade velocity (PSP), smooth pursuit (MSA)

Multimodal Diagnostics

Combining multiple modalities for synergistic information:

• PET + MRI: Amyloid/tau PET with structural MRI for atrophy
• CSF + imaging: Biomarker + neuroimaging integration
• Clinical + digital: Traditional scales + continuous monitoring

Blood-Based Biomarker Revolution

The most significant advance in neurodegenerative diagnostics (2020-2026):

• Ultrasensitive assays: Simoa, Erenna, LC-MS/MS enable plasma NfL, p-tau
• p-tau217: Emerging as most specific AD blood biomarker
• GFAP: Early AD detection, correlates with amyloid PET
• Combination panels: Aβ42/40 + p-tau217 + NfL for comprehensive profiling

Recent Updates

• 2026-03-17: Diagnostics dashboard created as navigation hub
• 2026-03-29: Expanded with AT(N) classification, disease-specific diagnostics, emerging technologies

See Also

• [Alzheimer's Disease](/diseases/alzheimers-disease)
• [Parkinson's Disease](/diseases/parkinsons-disease)
• [Biomarkers Overview](/biomarkers)
• [Clinical Trials](/clinical-trials)
• [Research Methods](/experiments)

References