Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Alzheimers Dement. 2014 Nov;10(6):713-723.e2. doi: 10.1016/j.jalz.2013.12.023. Epub 2014 Apr 8.

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

Author information

  • 1Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: F.Duits@vumc.nl.
  • 2Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands.
  • 3Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
  • 4Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry and Neuropsychology, Institute of Brain and Behaviour, University of Maastricht, Maastricht, The Netherlands.
  • 5Department of Neurochemistry and Psychiatry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA.
  • 6Department of Neurochemistry and Psychiatry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology, Queen Square, London, UK.
  • 7Department of Neurochemistry and Psychiatry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.
  • 8Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
  • 9KI-Alzheimer Disease Research Centre, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
  • 10Division of Geriatric Medicine, Department of Neuroscience and Locomotion, Linköping University, Linköping, Sweden.
  • 11Donders Institute for Brain Cognition and Behaviour, Radboud Alzheimer Center, Nijmegen, The Netherlands.
  • 12Memory and Dementia Centre, 3rd Department of Neurology, Aristotle University of Thessaloniki, "G. Papanicolaou" General Hospital, Thessaloniki, Greece.
  • 13Clinica Neurologica, University of Perugia, Perugia, Italy.
  • 14Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
  • 15Département de Neurologie & Institut de la Mémoire et de la Maladie d'Alzheimer Pavillon, Université Pierre et Marie Curie, François Lhermitte Hôpital de la Salpêtrière, Paris, France.
  • 16Center for Brain Health, New York University, School of Medicine, New York, NY, USA.
  • 17Sektion Gerontopsychiatrie, Universität Heidelberg, Heidelberg, Germany.
  • 18Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
  • 19Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.

Abstract

BACKGROUND:

We aimed to identify the most useful definition of the "cerebrospinal fluid Alzheimer profile," based on amyloid-ß1-42 (Aβ42), 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/Aβ42 ratio and 0.08 for the p-tau/Aβ42 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/Aβ42 ratio.

CONCLUSIONS:

A tau/Aβ42 ratio of >0.52 constitutes a robust cerebrospinal fluid Alzheimer profile. We recommend using this ratio to combine biomarkers.

Copyright © 2014. Published by Elsevier Inc.

KEYWORDS:

Alzheimer's disease; Amyloid-β(1-42); Biomarkers; Cerebrospinal fluid; Dementia; Differential diagnosis; Mild cognitive impairment; Predictive value; Tau

PMID:
24721526
[PubMed - in process]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk