Comparative analysis of cerebrospinal fluid biomarkers in the differential diagnosis of neurodegenerative dementia

• DOI: 10.1016/j.jalz.2015.10.009
• Publication Date: 2015-12-22T06:04:03Z
• Authors: Franc Llorens; Matthias Schmitz; André Karch; Maria Cramm; Peter Lange; Kerim Gherib; Daniela Varges; Christian Schmidt; Inga Zerr; Katharina Stoeck
• Keywords: Lewy Body Disease; diagnosis [Creutzfeldt-Jakob Syndrome]; tau Proteins; cerebrospinal fluid [Amyloid beta-Peptides]; cerebrospinal fluid [Lewy Body Disease]; physiopathology [Alzheimer Disease]; Creutzfeldt-Jakob Syndrome; Diagnosis, Differential; 03 medical and health sciences; 0302 clinical medicine; Alzheimer Disease; Humans; ddc:610; cerebrospinal fluid [Peptide Fragments]; physiopathology [Creutzfeldt-Jakob Syndrome]; Amyloid beta-Peptides; physiopathology [Lewy Body Disease]; diagnosis [Alzheimer Disease]; cerebrospinal fluid [Creutzfeldt-Jakob Syndrome]; Peptide Fragments; 3. Good health; cerebrospinal fluid [Alzheimer Disease]; cerebrospinal fluid [Biomarkers]; cerebrospinal fluid [tau Proteins]; diagnosis [Lewy Body Disease]; Biomarkers

AbstractIntroductionThe analysis of cerebrospinal fluid biomarkers gains importance in clinical routine and is effective in substantiating dementia diagnosis in the differential diagnostic context.MethodsWe evaluated the levels of β‐amyloid (Aβ) 42, Aβ40, tau, and P‐tau in a large patient population subdivided into prion diseases, tauopathies, synucleinopathies, and controls. Diagnostic test evaluation was assessed by ROC area under the curve analysis.ResultsHigh tau levels were detected in sporadic Creutzfeldt‐Jakob disease (sCJD) and high P‐tau levels in Alzheimer's disease (AD) and sCJD. Aβ40 was lower exclusively in prionopathies, but low Aβ42 was detected in AD, sCJD, and Lewy body dementia. When disease groups were stratified according to the underlying proteinopathy, we detected disease‐type specificities for all biomarkers. P‐tau/tau, Aβ42/40, Aβ42/tau, and Aβ40/tau ratios proved valuable in discriminating disease groups and controls, especially P‐tau/tau ratio in the identification of sCJD cases.DiscussionCombining the biomarker panel allows differentiating between various types of neurodegenerative dementias and contributes to a better understanding of their pathophysiological processes.