Document Detail


Cerebrospinal fluid beta-amyloid(1-42) in Alzheimer disease: differences between early- and late-onset Alzheimer disease and stability during the course of disease.
MedLine Citation:
PMID:  10369305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To study the diagnostic potential of the 42 amino acid form of beta-amyloid (beta-amyloid(1-42)) in cerebrospinal fluid (CSF) as a biochemical marker for Alzheimer disease (AD), the intra-individual biological variation of CSF-beta-amyloid(1-42) level in patients with AD, and the possible effects of differential binding between beta-amyloid and apolipoprotein E isoforms on CSF-beta-amyloid(1-42) levels. DESIGN: A 20-month prospective follow-up study. SETTING: Community population-based sample of consecutive patients with AD referred to the Piteå River Valley Hospital, Piteå, Sweden. PATIENTS: Fifty-three patients with AD (mean +/- SD age, 71.4 +/- 7.4 years) diagnosed according to the National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer's Disease and Related Disorders Association criteria and 21 healthy, age-matched (mean +/- SD age, 68.8 +/- 8.0 years) control subjects. MAIN OUTCOME MEASURES: Cerebrospinal fluid beta-amyloid(1-42) level--analyzed using enzyme-linked immunosorbent assay--and severity of dementia--analyzed using the Mini-Mental State Examination. RESULTS: Mean +/- SD levels of CSF-beta-amyloid(1-42) were decreased (P<.001) in patients with AD (709 +/- 304 pg/mL) compared with controls (1678 +/- 436 pg/mL). Most patients with AD (49 [92%] of 53 patients) had reduced levels (<1130 pg/mL). A highly significant correlation (r = 0.90; P<.001) between baseline and 1-year follow-up CSF-beta-amyloid(1-42) levels was found. There were no significant correlations between CSF-beta-amyloid(1-42) level and duration (r = -0.16) or severity (r = -0.02) of dementia. Low levels were also found in patients with mild dementia (Mini-Mental State Examination score, >25). CONCLUSIONS: The sensitivity of CSF-beta-amyloid(1-42) level as a diagnostic marker for AD is high. The intra-individual biological variation in CSF-beta-amyloid(1-42) level is low. Low CSF-beta-amyloid(1-42) levels are also found in the earlier stages of dementia in patients with AD. These findings suggest that CSF-beta-amyloid(1-42) analyses may be of value in the clinical diagnosis of AD, especially in the early course of the disease, when drug therapy may have the greatest potential of being effective but clinical diagnosis is particularly difficult.
Authors:
N Andreasen; C Hesse; P Davidsson; L Minthon; A Wallin; B Winblad; H Vanderstichele; E Vanmechelen; K Blennow
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of neurology     Volume:  56     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-06-29     Completed Date:  1999-06-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  673-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Rehabilitation, Piteå River Valley Hospital, Sweden. niels.andreasen@nll.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Alzheimer Disease / cerebrospinal fluid*,  diagnosis*
Amyloid beta-Protein / cerebrospinal fluid*
Apolipoprotein E3
Apolipoproteins E / genetics
Biological Markers / cerebrospinal fluid
Dementia / cerebrospinal fluid
Female
Follow-Up Studies
Humans
Male
Medical History Taking
Predictive Value of Tests
Prospective Studies
Protein Isoforms / genetics
Reference Values
Regression Analysis
Time Factors
Chemical
Reg. No./Substance:
0/Amyloid beta-Protein; 0/Apolipoprotein E3; 0/Apolipoproteins E; 0/Biological Markers; 0/Protein Isoforms
Comments/Corrections
Comment In:
Arch Neurol. 1999 Jun;56(6):655-6   [PMID:  10369301 ]

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