Cerebrospinal fluid biomarkers in the differential diagnosis of Alzheimer's disease from other cortical dementias
Cerebrospinal fluid biomarkers in the differential diagnosis of Alzheimer's disease from other cortical dementias
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DOI：
10.1136/jnnp.2010.207183
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发表时间：
2011-03-01
影响因子：
11
通讯作者：
Sarazin, Marie
中科院分区：
文献类型：
--
作者：
de Souza, Leonardo Cruz;Lamari, Foudil;Sarazin, Marie
背景考虑到大多数语义性痴呆（SD）和额颞叶痴呆（FTD）患者没有表现出死后阿尔茨海默病（AD）的病理学，脑脊液（CSF）生物标志物可能对区分这些患者与AD患者有价值。此外，生物标志物可用于识别具有AD的非典型表型表现的患者，例如后皮质萎缩（PCA）和原发性进行性非流畅性失语症（PNFLA）。164例AD（n=60）、PCA（n=15）、行为变异FTD（n=27）、SD（n=19）、PNFLA（n=26）和功能性认知障碍（FCD，n=17）。结果发现P-Tau/A β（42）比值是区分AD与FTD和SD的最佳生物标志物，其敏感性分别为91.7%和98.3%，特异性分别为92.6%和84.2%。正如预期的那样，生物标志物在区分AD与PNFLA和PCA方面效果较差，因为显著比例的PCA和PNFLA患者（分别为60%和61.5%）同时具有T-Tau/A β（42）和P-Tau/A β（42）比值的改变。结论P-Tau/A β（42）比值是鉴别AD与FTD和SD的有效工具，FTD和SD的病理过程与AD不同。生物标志物可用于识别具有非典型AD表型的患者，包括PNFLA和PCA。的
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 (A beta(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/A beta(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/A beta(42) and P-Tau/A beta(42) ratios. None of the FCD patients had a typical AD CSF profile or abnormal T-tau/Ab42 or P-Tau/A beta(42) ratios.Conclusion The P-Tau/A beta(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. the