The cerebrospinal fluid "Alzheimer profile": Easily said, but what does it mean?

被引：232

作者：

Duits, Flora H. ^{[1
,2
]}

Teunissen, Charlotte E. ^{[3
]}

Bouwman, Femke H. ^{[1
,2
]}

Visser, Pieter-Jelle ^{[1
,2
,4
]}

Mattsson, Niklas ^{[6
]}

Zetterberg, Henrik ^{[7
]}

Blennow, Kaj ^{[5
]}

Hansson, Oskar ^{[8
]}

Minthon, Lennart ^{[8
]}

Andreasen, Niels ^{[9
]}

Marcusson, Jan ^{[10
]}

Wallin, Anders ^{[5
]}

Rikkert, Marcel Olde ^{[11
]}

Tsolaki, Magda ^{[12
]}

Parnetti, Lucilla ^{[13
]}

Herukka, Sanna-Kaisa ^{[14
,15
]}

Hampel, Harald ^{[16
,17
]}

De Leon, Mony J. ^{[18
]}

Schroeder, Johannes ^{[19
]}

Aarsland, Dag ^{[20
]}

Blankenstein, Marinus A. ^{[3
]}

Scheltens, Philip ^{[1
,2
]}

van der Flier, Wiesje M. ^{[21
]}

机构：

[1] Vrije Univ Amsterdam, Med Ctr, Alzheimer Ctr, Amsterdam, Netherlands

[2] Vrije Univ Amsterdam, Med Ctr, Dept Neurol, Amsterdam, Netherlands

[3] Vrije Univ Amsterdam, Med Ctr, Dept Clin Chem, Amsterdam, Netherlands

[4] Univ Maastricht, Inst Brain & Behav, Dept Psychiat & Neuropsychol, Maastricht, Netherlands

[5] Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Psychiat & Neurochem, Molndal, Sweden

[6] Ctr Imaging Neurodegenerat Dis, Dept Vet Affairs Med Ctr, San Francisco, CA USA

[7] UCL Inst Neurol, London, England

[8] Lund Univ, Dept Clin Sci, Clin Memory Res Unit, Lund, Sweden

[9] Karolinska Univ Hosp, KI Alzheimer Dis Res Ctr, Karolinska Inst, Stockholm, Sweden

[10] Linkoping Univ, Dept Neurosci & Locomot, Div Geriatr Med, Linkoping, Sweden

[11] Donders Inst Brain Cognit & Behav, Radboud Alzheimer Ctr, Nijmegen, Netherlands

[12] Aristotle Univ Thessaloniki, G Papanicolaou Gen Hosp, Memory & Dementia Ctr, Dept Neurol 3, GR-54006 Thessaloniki, Greece

[13] Univ Perugia, Neurol Clin, I-06100 Perugia, Italy

[14] Univ Eastern Finland, Dept Neurol, Kuopio, Finland

[15] Kuopio Univ Hosp, SF-70210 Kuopio, Finland

[16] Univ Paris 06, Francois Lhermitte Hop Salpetriere, Dept Neurol, Paris, France

[17] Univ Paris 06, Francois Lhermitte Hop Salpetriere, Inst Memoire & Malad Alzheimer Pavillon, Paris, France

[18] NYU, Sch Med, Ctr Brain Hlth, New York, NY USA

[19] Heidelberg Univ, Sekt Gerontopsychiat, Heidelberg, Germany

[20] Stavanger Univ Hosp, Ctr Age Related Med, Stavanger, Norway

[21] Vrije Univ Amsterdam, Med Ctr, Dept Epidemiol & Biostat, Amsterdam, Netherlands

来源：

ALZHEIMERS & DEMENTIA | 2014年 / 10卷 / 06期

关键词：

Dementia; Alzheimer's disease; Mild cognitive impairment; Cerebrospinal fluid; Amyloid-beta(1-42); Tau; Biomarkers; Differential diagnosis; Predictive value; MILD COGNITIVE IMPAIRMENT; PROGRESSIVE SUPRANUCLEAR PALSY; CSF BIOMARKERS; ASSOCIATION WORKGROUPS; DIAGNOSTIC GUIDELINES; NATIONAL INSTITUTE; RESEARCH CRITERIA; DISEASE; DEMENTIA; TAU;

D O I：

10.1016/j.jalz.2013.12.023

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: We aimed to identify the most useful definition of the "cerebrospinal fluid Alzheimer profile," based on amyloid-beta(1-42) (A beta(42)), total tau, and phosphorylated tau (p-tau), for diagnosis and prognosis of Alzheimer's disease (AD). Methods: We constructed eight Alzheimer profiles with previously published combinations, including regression formulas and simple ratios. We compared their diagnostic accuracy and ability to predict dementia due to AD in 1385 patients from the Amsterdam Dementia Cohort. Results were validated in an independent cohort (n = 1442). Results: Combinations outperformed individual biomarkers. Based on the sensitivity of the best performing regression formulas, cutoffs were chosen at 0.52 for the tau/A beta(42) ratio and 0.08 for the p-tau/A beta(42) ratio. Ratios performed similar to formulas (sensitivity, 91%-93%; specificity, 81%-84%). The same combinations best predicted cognitive decline in mild cognitive impairment patients. Validation confirmed these results, especially regarding the tau/A beta(42) ratio. Conclusions: A tau/A beta(42) ratio of >0.52 constitutes a robust cerebrospinal fluid Alzheimer profile. We recommend using this ratio to combine biomarkers. (C) 2014 Published by Elsevier Inc. on behalf of The Alzheimer's Association.

引用

页码：713 / 723

页数：11

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