PT  - JOURNAL ARTICLE
AU  - N.S.M. Schoonenboom
AU  - F.E. Reesink
AU  - N.A. Verwey
AU  - M.I. Kester
AU  - C.E. Teunissen
AU  - P.M. van de Ven
AU  - Y.A.L. Pijnenburg
AU  - M.A. Blankenstein
AU  - A.J. Rozemuller
AU  - P. Scheltens
AU  - W.M. van der Flier
TI  - Cerebrospinal fluid markers for differential dementia diagnosis in a large memory clinic cohort
AID  - 10.1212/WNL.0b013e31823ed0f0
DP  - 2012 Jan 03
TA  - Neurology
PG  - 47--54
VI  - 78
IP  - 1
4099  - http://n.neurology.org/content/78/1/47.short
4100  - http://n.neurology.org/content/78/1/47.full
SO  - Neurology2012 Jan 03; 78
AB  - Objective: To determine how amyloid β 42 (Aβ42), total tau (t-tau), and phosphorylated tau (p-tau) levels in CSF behave in a large cohort of patients with different types of dementia. Methods: Baseline CSF was collected from 512 patients with Alzheimer disease (AD) and 272 patients with other types of dementia (OD), 135 patients with a psychiatric disorder (PSY), and 275 patients with subjective memory complaints (SMC). Aβ42, t-tau, and p-tau (at amino acid 181) were measured in CSF by ELISA. Autopsy was obtained in a subgroup of 17 patients. Results: A correct classification of patients with AD (92%) and patients with OD (66%) was accomplished when CSF Aβ42 and p-tau were combined. Patients with progressive supranuclear palsy had normal CSF biomarker values in 90%. Patients with Creutzfeldt-Jakob disease demonstrated an extremely high CSF t-tau at a relatively normal CSF p-tau. CSF AD biomarker profile was seen in 47% of patients with dementia with Lewy bodies (DLB), 38% in corticobasal degeneration (CBD), and almost 30% in frontotemporal lobar degeneration (FTLD) and vascular dementia (VaD). PSY and SMC patients had normal CSF biomarkers in 91% and 88%. Older patients are more likely to have a CSF AD profile. Concordance between clinical and neuropathologic diagnosis was 85%. CSF markers reflected neuropathology in 94%. Conclusion: CSF Aβ42, t-tau, and p-tau are useful in differential dementia diagnosis. However, in DLB, FTLD, VaD, and CBD, a substantial group exhibit a CSF AD biomarker profile, which requires more autopsy confirmation in the future. Aβ42=amyloid β 42; AD=Alzheimer disease; BNE=BrainNet Europe; CBD=corticobasal degeneration; CI=confidence interval; CJD=Creutzfeldt-Jakob disease; DLB=dementia with Lewy bodies; FTLD=frontotemporal lobar degeneration; IQR=interquartile range; MMSE=Mini-Mental State Examination; NINDS=National Institute of Neurological Disorders and Stroke; OD=other types of dementia; OR=odds ratio; p-tau=phosphorylated tau; PSP=progressive supranuclear palsy; PSY=psychiatric disorder; SMC=subjective memory complaints; t-tau=total tau; VaD=vascular dementia