CSF and MRI markers independently contribute to the diagnosis of Alzheimer's disease

Background: Decreased amyloid P (1-42) (A beta 42) and increased (phosphorylated) tau in cerebrospinal fluid (CSF) are considered to be a reflection of plaques, tangles, and neuronal degeneration in Alzheimer's disease (AD). Atrophy of the medial temporal lobe (MTA) 011 magnetic resonance imaging (MRI) reflects neuronal loss in this area. Objective: To compare diagnostic accuracy of CSF biomarkers and NITA in AD versus controls. Methods: A beta 42, tau and tau phosphorylated at threonine 181 (Ptau-181) were measured in CSF from 61 AD patients and 32 controls by sandwich enzyme-linked immunosorbent assay. A CSF biomarker profile for AD was constructed. NITA was rated visually on MRI. Results: When AD patients and controls were evaluated separately, no correlations were present between the CSF markers and NITA score. Both NITA and CSF biomarker profile were independently associated with the diagnosis AD (NITA: OR (95% Cl) = 28 (3-239); CSF biomarker profile: OR (95% Q = 57 (13-262)). Among individuals younger than 65 years old and without NITA 60% suffered AD, and the finding of an abnormal CSF biomarker profile was limited to AD patients only. Conclusions: NITA and CSF biomarkers seem to be of incremental value for the diagnosis AD. CSF analysis is most sensitive in the absence of NITA, and especially among early-onset AD patients. (c) 2007 Published by Elsevier Inc.