| CSF biomarkers predict a more malignant outcome in Alzheimer disease. | |
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MedLine Citation:
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PMID: 20458070 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate if patterns of CSF biomarkers (T-tau, P-tau, and Abeta42) can predict cognitive progression, outcome of cholinesterase inhibitor (ChEI) treatment, and mortality in Alzheimer disease (AD). METHODS: We included outpatients with AD (n = 151) from a prospective treatment study with ChEI. At baseline, patients underwent cognitive assessments and lumbar puncture. The patients were assessed longitudinally. The 5-year survival rate was evaluated. CSF-Abeta42, T-tau, and P-tau were analyzed at baseline. K-means cluster analysis including the 3 CSF biomarkers was carried out. RESULTS: Cluster 1 contained 87 patients with low levels of Abeta42 and relatively low levels of T-tau and P-tau. Cluster 2 contained 52 patients with low levels of Abeta42 and intermediate levels of T-tau and P-tau. Cluster 3 contained 12 patients with low levels of Abeta42 and very high levels of CSF T-tau and P-tau. There were no differences between the clusters regarding age, gender, years of education, baseline instrumental activities of daily living, or APOE genotype. Even though there was no difference between cluster 3 and the other clusters in disease duration or global rating, the patients in cluster 3 performed worse on cognitive tests already at baseline. Patients in cluster 3 exhibited a very poor outcome of ChEI treatment. Finally, cognition deteriorated faster over time and the mortality rate was substantially increased in cluster 3. CONCLUSION: A subgroup of patients with Alzheimer disease with extreme levels of CSF biomarkers exhibits worse clinical outcomes over time, including faster progression of cognitive deficits, no response to ChEI treatment, and a higher mortality. |
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Authors:
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A K Wallin; K Blennow; H Zetterberg; E Londos; L Minthon; O Hansson |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurology Volume: 74 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-11 Completed Date: 2010-07-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 1531-7 Citation Subset: AIM; IM |
Affiliation:
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Malm? University Hospital, SE-205 02 Malm?, Sweden. asa.k.wallin@skane.se |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Alzheimer Disease / diagnosis*, drug therapy, mortality Amyloid beta-Protein / cerebrospinal fluid* Biological Markers / cerebrospinal fluid Cholinesterase Inhibitors / therapeutic use Disease Progression Female Humans Longitudinal Studies Male Neuropsychological Tests Outcome Assessment (Health Care) Peptide Fragments / cerebrospinal fluid* Predictive Value of Tests Prognosis Prospective Studies Sensitivity and Specificity Severity of Illness Index Survival Rate Time Factors Treatment Outcome tau Proteins / cerebrospinal fluid* |
| Chemical | |
Reg. No./Substance:
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0/Amyloid beta-Protein; 0/Biological Markers; 0/Cholinesterase Inhibitors; 0/Peptide Fragments; 0/amyloid beta-protein (1-42); 0/tau Proteins |
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