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CNS Neurosci Ther. 2018 Aug;24(8):734-740. doi: 10.1111/cns.12814. Epub 2018 Feb 17.

Evaluation of cerebrospinal fluid phosphorylated tau231 as a biomarker in the differential diagnosis of Alzheimer's disease and vascular dementia.

Author information

1
Department of Neurology, General Hospital Varaždin, Varaždin, Croatia.
2
Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia.
3
Department of Anatomy, University of Zagreb School of Medicine, Zagreb, Croatia.
4
Department of Neurology, University Hospital Centre "Zagreb", University of Zagreb School of Medicine, Zagreb, Croatia.
5
Department of Medical Statistics, Epidemiology and Medical Informatics, School of Public Health "Andrija Štampar", University of Zagreb School of Medicine, Zagreb, Croatia.
6
Department of Pathology, University of Zagreb School of Medicine, Zagreb, Croatia.
7
Fishberg Department of Neuroscience, Ronald M. Loeb Center for Alzheimer's Disease, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
8
University Psychiatric Hospital Vrapče, University of Zagreb School of Medicine, Zagreb, Croatia.

Abstract

BACKGROUND:

The diagnosis of either Alzheimer's disease (AD) or vascular dementia (VaD) is still largely based on clinical guidelines and exclusion of other diseases that may lead to dementia.

AIMS:

In this study, we assessed whether the use of sensitive and specific biomarkers such as phosphorylated tau proteins could contribute to an earlier and more accurate diagnosis of AD and VaD, as well as to their differentiation.

MATERIAL AND METHODS:

A total of 198 patients, of which 152 had AD, 28 VaD, and 18 were healthy controls (HC), were included in the analyses. We analyzed cerebrospinal fluid (CSF) levels of total tau protein (t-tau), tau protein phosphorylated at threonine 231 (p-tau231), and factor score (FS) determined by combination of p-tau231 and Mini-Mental State Examination (MMSE) in patients with AD and VaD, as well as in HC. We tested the diagnostic accuracy of these biomarkers in the CSF and FS (p-tau231, MMSE) in differentiating AD from VaD and HC.

RESULTS:

Total tau levels were significantly elevated in subjects with AD compared to HC, as well as in VaD subjects compared to HC.

DISCUSSION:

p-tau231 levels were significantly higher in patients with ADvsHC as well in patients with VaD vsHC. p-tau231 levels did not distinguish AD from VaD patients. Importantly, FS(p-tau231 and MMSE) showed statistically significant differences in the distribution of subjects with AD and VaD.

CONCLUSION:

These results indicate that FS (p-tau231 and MMSE) has a strong potential to provide an early distinction between AD and VaD.

KEYWORDS:

Alzheimer's disease; biomarkers; cerebrospinal fluid; tau proteins; vascular dementia

PMID:
29453935
PMCID:
PMC6047904
[Available on 2019-08-01]
DOI:
10.1111/cns.12814

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