Cerebrospinal fluid tau and β-amyloid -: How well do these biomarkers reflect autopsy-confirmed dementia diagnoses?
Cerebrospinal fluid tau and β-amyloid -: How well do these biomarkers reflect autopsy-confirmed dementia diagnoses?
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DOI：
10.1001/archneur.60.12.1696
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发表时间：
2003-12-01
影响因子：
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通讯作者：
Trojanowski, JQ
中科院分区：
文献类型：
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作者：
Clark, CM;Xie, S;Trojanowski, JQ
背景：Tau和β-淀粉样蛋白（Abeta）是阿尔茨海默病（AD）的诊断生物标志物。先前的研究报告了它们与AD和其他痴呆症的临床诊断的关系。为了了解它们作为疾病特异性病理学预测因子的价值，在生活中测定的水平必须与混合痴呆组和认知正常受试者的明确诊断相关联。目的：在不同患者组中将死前脑脊液（CSF）tau和Abeta水平与明确的痴呆诊断相关联;计算CSF tau和Abeta的统计学。设计：前瞻性研究。设置：10个诊所在神经退行性痴呆的诊断方面有经验。患者：106例痴呆患者和4例明确诊断的认知正常受试者，以及69例临床诊断的认知正常受试者。主要结果测量：CSF tau和Abeta与最终诊断的相关性。结果：74例AD患者的平均tau水平为612 pg/mL，10例额叶痴呆患者为272 pg/mL，3例路易体痴呆患者为282 pg/mL，73例认知正常对照受试者为140 pg/mL。20例AD患者的Tau低于334 pg/mL。与额叶痴呆患者（133 fmol/mL）和对照受试者（109 fmol/mL）相比，AD患者（61 fmol/mL）的Abeta（42）降低，但与路易体痴呆患者（14 fmol/mL）或朊病毒病患者（60 fmol/mL）相比则无此差异。然而，一些AD患者的水平低于认知正常队列的平均+/-2 SD。
Background: Tau and P-amyloid (Abeta) are proposed diagnostic biomarkers for Alzheimer disease (AD). Previous studies report their relationship to clinical diagnoses of AD and other dementias. To understand their value as predictors of disease-specific patholody, levels determined during life must be correlated with definitive diagnoses in mixed dementia groups and cognitively normal subjects.Objectives: To correlate antemortem cerebrospinal fluid (CSF) tau and Abeta levels with definitive dementia diagnosis in a diverse group of patients; to calculate statistics for CSF tau and Abeta.Design: Prospective study.Setting: Ten clinics experienced in the diagnosis of neurodegenerative dementias.Patients: One hundred six patients with dementia and 4 cognitively normal subjects with a definitive diagnosis, and 69 clinically diagnosed cognitively normal subjects.Main Outcome Measures: Correlation of CSF tau and Abeta with final diagnosis.Results: Mean tau level was 612 pg/mL for the 74 patients with AD, 272 pg/mL for 10 patients with frontal dementia, 282 pg/mL for 3 patients with dementia with Lewy bodies, and 140 pg/mL for 73 cognitively normal control subjects. Tau was less than 334 pg/mL for 20 patients with AD. Abeta(42) was reduced in patients with AD (61 fmol/mL) compared with patients with frontal dementia (133 fmol/mL) and control subjects (109 fmol/mL), but not compared with patients with dementia with Lewy bodies (14 fmol/mL) or prion disease (60 fmol/mL).Conclusions: Elevated CSF tau levels are associated with AD pathology and can help discriminate AD from other dementing disorders. However, some patients with AD have a level less than the mean +/- 2 SDs of the cognitively normal cohort.