RT Journal Article
SR Electronic
T1 Cerebrospinal fluid markers for differential dementia diagnosis in a large memory clinic cohort
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 47
OP 54
DO 10.1212/WNL.0b013e31823ed0f0
VO 78
IS 1
A1 N.S.M. Schoonenboom
A1 F.E. Reesink
A1 N.A. Verwey
A1 M.I. Kester
A1 C.E. Teunissen
A1 P.M. van de Ven
A1 Y.A.L. Pijnenburg
A1 M.A. Blankenstein
A1 A.J. Rozemuller
A1 P. Scheltens
A1 W.M. van der Flier
YR 2012
UL http://n.neurology.org/content/78/1/47.abstract
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