Document Detail

Cerebrospinal fluid biomarkers in the differential diagnosis of Alzheimer's disease from other cortical dementias.
MedLine Citation:
PMID:  20802215     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Considering that most semantic dementia (SD) and frontotemporal dementia (FTD) patients show no post-mortem Alzheimer's disease (AD) pathology, cerebrospinal fluid (CSF) biomarkers may be of value for distinguishing these patients from those with AD. Additionally, biomarkers may be useful for identifying patients with atypical phenotypic presentations of AD, such as posterior cortical atrophy (PCA) and primary progressive non-fluent or logopenic aphasia (PNFLA).
METHODS: The authors investigated CSF biomarkers (beta-amyloid 1-42 (Aβ(42)), total tau (T-tau) and phosphorylated tau (P-tau)) in 164 patients with AD (n=60), PCA (n=15), behavioural variant FTD (n=27), SD (n=19), PNFLA (n=26) and functional cognitive disorders (FCD, n=17). The authors then examined the diagnostic value of these CSF biomarkers in distinguishing these patients from those with AD.
RESULTS: The P-Tau/Aβ(42) ratio was found to be the best biomarker for distinguishing AD from FTD and SD, with a sensitivity of 91.7% and 98.3%, respectively, and a specificity of 92.6% and 84.2%, respectively. As expected, biomarkers were less effective in differentiating AD from PNFLA and PCA, as significant proportions of PCA and PNFLA patients (60% and 61.5%, respectively) had concurrent alterations of both T-tau/Aβ(42) and P-Tau/Aβ(42) ratios. None of the FCD patients had a typical AD CSF profile or abnormal T-tau/Aβ(42) or P-Tau/Aβ(42) ratios.
CONCLUSION: The P-Tau/Aβ(42) ratio is a useful tool to distinguish AD from both FTD and SD, which are known to involve pathological processes distinct from AD. Biomarkers could be useful for identifying patients with an atypical AD phenotype that includes PNFLA and PCA.
Leonardo Cruz de Souza; Foudil Lamari; Serge Belliard; Claude Jardel; Caroline Houillier; Raphael De Paz; Bruno Dubois; Marie Sarazin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-27
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  82     ISSN:  1468-330X     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-17     Completed Date:  2011-04-04     Revised Date:  2011-05-11    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  240-6     Citation Subset:  IM    
CRICM, UPMC Univ Paris 06, Pitié-Salpêtrière Hospital, Paris, France.
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MeSH Terms
Alzheimer Disease / cerebrospinal fluid*,  diagnosis
Amyloid beta-Peptides / cerebrospinal fluid
Aphasia, Primary Progressive / cerebrospinal fluid,  diagnosis
Biological Markers / cerebrospinal fluid
Cerebral Cortex / pathology
Cognition Disorders / cerebrospinal fluid,  diagnosis
Dementia / cerebrospinal fluid*,  diagnosis
Diagnosis, Differential
Frontotemporal Dementia / cerebrospinal fluid,  diagnosis
Middle Aged
Peptide Fragments / cerebrospinal fluid
tau Proteins / cerebrospinal fluid
Reg. No./Substance:
0/Amyloid beta-Peptides; 0/Biological Markers; 0/Peptide Fragments; 0/amyloid beta-protein (1-42); 0/tau Proteins

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