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J Neurol Sci. 2017 Nov 15;382:91-95. doi: 10.1016/j.jns.2017.09.039. Epub 2017 Sep 28.

CSF biomarkers β-amyloid, tau proteins and a-synuclein in the differential diagnosis of Parkinson-plus syndromes.

Author information

1
1st Department of Neurology, National and Kapodistrian University of Athens, Eginition Hospital, 72-74 Vassilisis Sofias Avenue, Athens P.C.:11528, Greece. Electronic address: vconstan@med.uoa.gr.
2
1st Department of Neurology, National and Kapodistrian University of Athens, Eginition Hospital, 72-74 Vassilisis Sofias Avenue, Athens P.C.:11528, Greece.
3
Division of Basic Neurosciences, Biomedical Research Foundation, Academy of Athens, 4 Soranou Ephessiou Street, Athens P.C. 11527, Greece.

Abstract

INTRODUCTION:

Differential diagnosis of Parkinson-plus patients (PSP, CBD, MSA) and Parkinson's disease (PD) patients is often not straightforward, particularly in atypical cases or at the initial stages of the diseases. Classic CSF biomarkers (amyloid-beta - Aβ42, tau protein - τT and phosphorylated tau protein - τP-181) are established biomarkers in the diagnosis of Alzheimer's disease (AD). CSF a-synuclein (α-syn) has emerged as a promising biomarker in patients with Parkinsonism. The aim of this study was to analyze the CSF biochemical profile of patients with Parkinsonism.

METHODS:

We analyzed the CSF biomarker profile (Aβ42, τT, τP-181, α-syn) and all relevant ratios in 68 patients with Parkinsonism (19 PSP, 15 MSA, 17 CBD, 17 PD) and 18 controls, diagnosed by latest established diagnostic criteria.

RESULTS:

CBD patients exhibited elevated τT and decreased Aβ42 compared to the other groups. Five CBD, one PSP patient and one control had a typical AD CSF profile. After exclusion of these patients, the τT/Aβ42 ratio was significantly elevated in MSA patients compared to PD patients and provided excellent specificity and adequate sensitivity in their differential diagnosis.

CONCLUSION:

CSF biochemical profile analysis is important in distinguishing AD patients with a CBS phenotype from non-AD CBS patients. The τT/Aβ42 ratio is useful in the differential diagnosis of MSA from PD.

KEYWORDS:

Beta amyloid; Biomarkers; Cerebrospinal fluid; Parkinson-plus; Tau proteins; a-Synuclein

PMID:
29111028
DOI:
10.1016/j.jns.2017.09.039
[Indexed for MEDLINE]

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