We investigated whether the cerebrospinal fluid (CSF) biomarkers beta-amyloid 1-42 (Abeta1-42), total tau (t-tau) protein and tau protein phosphorylated at threonine 181 (p-tau181) could discriminate Alzheimer's disease (AD) from vascular dementia (VD) patients. CSF samples of Abeta1-42, t-tau, and p-tau181 were collected from probable AD (n=35), probable AD with white matter changes (WMC) indicative of concomitant cerebrovascular disorder (CVD, n=31), VD (n=20), and an age-matched subgroup of patients with other neurological disorders (OND) without cognitive impairment (n=24). AD patients showed very low Abeta1-42 levels (median=393 pg/ml). Abeta1-42, but not t-tau, differentiated AD from VD patients. However, the markers did not discriminate AD vs. AD plus WMC. In particular, both subgroups showed similar CSF biomarkers but they were significantly different from VD. ROC analysis showed that Abeta1-42 could discriminate AD from VD (AUC=0.85). The cutoff of 493 pg/ml gave sensitivity and specificity values of 77% and 80%, respectively. Similar results were obtained when Abeta1-42 was employed to discriminate AD with WMC from VD (95% specificity and 60% sensitivity, but with cutoff of 750 pg/ml). T-tau increased aspecifically in all cognitively impaired patients. P-tau181 performed better than t-tau in discriminating AD (with or without WMC) vs. VD. In conclusion, Abeta1-42 proved to be a valuable tool to discriminate AD vs. VD patients and possibly to improve diagnostic accuracy in clinical forms, improperly classified as "mixed dementia" based on radiological vascular lesions.

Stefani, A., Bernardini, S., Panella, M., Pierantozzi, M., Nuccetelli, M., Koch, G., et al. (2005). AD with subcortical white matter lesions and vascular dementia: CSF markers for differential diagnosis. JOURNAL OF THE NEUROLOGICAL SCIENCES, 237(1-2), 83-88 [10.1016/j.jns.2005.05.016].

AD with subcortical white matter lesions and vascular dementia: CSF markers for differential diagnosis

STEFANI, ALESSANDRO;BERNARDINI, SERGIO;PIERANTOZZI, MARIANGELA;URBANI, ANDREA;MARTORANA, ALESSANDRO;ORLACCHIO, ANTONIO;FEDERICI, GIORGIO;BERNARDI, GIORGIO
2005-10-15

Abstract

We investigated whether the cerebrospinal fluid (CSF) biomarkers beta-amyloid 1-42 (Abeta1-42), total tau (t-tau) protein and tau protein phosphorylated at threonine 181 (p-tau181) could discriminate Alzheimer's disease (AD) from vascular dementia (VD) patients. CSF samples of Abeta1-42, t-tau, and p-tau181 were collected from probable AD (n=35), probable AD with white matter changes (WMC) indicative of concomitant cerebrovascular disorder (CVD, n=31), VD (n=20), and an age-matched subgroup of patients with other neurological disorders (OND) without cognitive impairment (n=24). AD patients showed very low Abeta1-42 levels (median=393 pg/ml). Abeta1-42, but not t-tau, differentiated AD from VD patients. However, the markers did not discriminate AD vs. AD plus WMC. In particular, both subgroups showed similar CSF biomarkers but they were significantly different from VD. ROC analysis showed that Abeta1-42 could discriminate AD from VD (AUC=0.85). The cutoff of 493 pg/ml gave sensitivity and specificity values of 77% and 80%, respectively. Similar results were obtained when Abeta1-42 was employed to discriminate AD with WMC from VD (95% specificity and 60% sensitivity, but with cutoff of 750 pg/ml). T-tau increased aspecifically in all cognitively impaired patients. P-tau181 performed better than t-tau in discriminating AD (with or without WMC) vs. VD. In conclusion, Abeta1-42 proved to be a valuable tool to discriminate AD vs. VD patients and possibly to improve diagnostic accuracy in clinical forms, improperly classified as "mixed dementia" based on radiological vascular lesions.
15-ott-2005
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/26 - NEUROLOGIA
English
Con Impact Factor ISI
Diagnosis, Differential; ROC Curve; Humans; Alzheimer Disease; Brain; Aged; tau Proteins; Cognition Disorders; Dementia, Vascular; Enzyme-Linked Immunosorbent Assay; Neuropsychological Tests; Biological Markers; Female; Male
Stefani, A., Bernardini, S., Panella, M., Pierantozzi, M., Nuccetelli, M., Koch, G., et al. (2005). AD with subcortical white matter lesions and vascular dementia: CSF markers for differential diagnosis. JOURNAL OF THE NEUROLOGICAL SCIENCES, 237(1-2), 83-88 [10.1016/j.jns.2005.05.016].
Stefani, A; Bernardini, S; Panella, M; Pierantozzi, M; Nuccetelli, M; Koch, G; Urbani, A; Giordano, A; Martorana, A; Orlacchio, A; Federici, G; Bernardi, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/28274
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