Document Detail


CSF biomarkers predict a more malignant outcome in Alzheimer disease.
MedLine Citation:
PMID:  20458070     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A K Wallin; K Blennow; H Zetterberg; E Londos; L Minthon; O Hansson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  74     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-11     Completed Date:  2010-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1531-7     Citation Subset:  AIM; IM    
Affiliation:
Malm? University Hospital, SE-205 02 Malm?, Sweden. asa.k.wallin@skane.se
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MeSH Terms
Descriptor/Qualifier:
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:
0/Amyloid beta-Protein; 0/Biological Markers; 0/Cholinesterase Inhibitors; 0/Peptide Fragments; 0/amyloid beta-protein (1-42); 0/tau Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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