Combined CSF tau, p-tau181 and amyloid-β 38/40/42 for diagnosing Alzheimer's disease

被引:124
作者
Welge, Volker [1 ]
Fiege, Oliver [1 ]
Lewczuk, Piotr [2 ]
Mollenhauer, Brit [3 ]
Esselmann, Hermann [2 ]
Klafki, Hans-Wolfgang [1 ]
Wolf, Stefanie [3 ]
Trenkwalder, Claudia [4 ]
Otto, Markus [5 ]
Kornhuber, Johannes [2 ]
Wiltfang, Jens [1 ]
Bibl, Mirko [1 ]
机构
[1] Univ Duisburg Essen, Klin Psychiat & Psychotherapie, Rhein Kliniken Essen, D-45147 Essen, Germany
[2] Univ Erlangen Nurnberg, Dept Psychiat & Psychotherapy, D-91054 Erlangen, Germany
[3] Univ Gottingen, Dept Psychiat, D-37075 Gottingen, Germany
[4] Univ Gottingen, Paracelsus Elena Klin, Kassel, Germany
[5] Univ Ulm, Dept Neurol, D-7900 Ulm, Germany
关键词
Alzheimer's disease; Cerebrospinal fluid; Amyloid-beta peptides; Biomarkers; ELISA; Electrochemiluminescence; CEREBROSPINAL-FLUID; LEWY BODIES; DEMENTIA; RATIO; PEPTIDES; A-BETA-42; A-BETA-1-42(43); GUIDELINES; CONSENSUS; PATTERNS;
D O I
10.1007/s00702-008-0177-6
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Cerebrospinal fluid (CSF) concentrations of amyloid-beta (A beta) 1-38, 1-40, 1-42, total-tau and phospho-tau in samples from 156 patients with Alzheimer's disease (AD) (n = 44), depressive cognitive complainers (DCC, n = 25) and various other forms of non-Alzheimer dementias (NAD, n = 87) were analyzed by electrochemiluminescence and enzyme linked immunosorbent assay, respectively. A significant decrease of CSF A beta 1-42 was the most powerful single marker for differentiation of AD from DCC, yielding accuracies of beyond 85%. Increased p-tau and the ratio A beta 1-42/A beta 1-38 yielded accuracies of beyond 80 and 85%, respectively, to discriminate AD versus NAD. Combining p-tau with A beta 1-42/A beta 1-38 resulted in a sensitivity of 94% for detection of AD and 85% specificity for excluding NAD. Decreased CSF A beta 1-42 represents a core biomarker for AD. The lack of specificity for exclusion of NAD can be most effectively compensated by the ratio A beta 1-42/A beta 1-38. The ratio A beta 1-42/A beta 1-38/p-tau powerfully discriminates AD versus NAD and fulfils the accuracy requirements for an applicable screening and differential diagnostic AD biomarker.
引用
收藏
页码:203 / 212
页数:10
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