Abstract
We investigated whether the cerebrospinal fluid (CSF) biomarkers beta-amyloid 1-42 (Aβ1-42), 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 Aβ1-42, 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 Aβ1-42 levels (median = 393 pg/ml). Aβ1-42, 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 Aβ1-42 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 Aβ1-42 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, Aβ1-42 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.
| Original language | English |
|---|---|
| Pages (from-to) | 83-88 |
| Number of pages | 6 |
| Journal | Journal of the Neurological Sciences |
| Volume | 237 |
| Issue number | 1-2 |
| DOIs | |
| Publication status | Published - Oct 15 2005 |
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Keywords
- Biomarkers
- Cerebro-vascular disorder
- Dementia
- Diagnosis
- White Matter Changes
ASJC Scopus subject areas
- Ageing
- Clinical Neurology
- Surgery
- Developmental Neuroscience
- Neurology
- Neuroscience(all)
Cite this
AD with subcortical white matter lesions and vascular dementia : CSF markers for differential diagnosis. / Stefani, Alessandro; Bernardini, Sergio; Panella, Marta; Pierantozzi, Mariangela; Nuccetelli, Marzia; Koch, Giacomo; Urbani, Andrea; Giordano, Angela; Martorana, Alessandro; Orlacchio, Antonio; Federici, Giorgio; Bernardi, Giorgio.
In: Journal of the Neurological Sciences, Vol. 237, No. 1-2, 15.10.2005, p. 83-88.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - AD with subcortical white matter lesions and vascular dementia
T2 - CSF markers for differential diagnosis
AU - Stefani, Alessandro
AU - Bernardini, Sergio
AU - Panella, Marta
AU - Pierantozzi, Mariangela
AU - Nuccetelli, Marzia
AU - Koch, Giacomo
AU - Urbani, Andrea
AU - Giordano, Angela
AU - Martorana, Alessandro
AU - Orlacchio, Antonio
AU - Federici, Giorgio
AU - Bernardi, Giorgio
PY - 2005/10/15
Y1 - 2005/10/15
N2 - We investigated whether the cerebrospinal fluid (CSF) biomarkers beta-amyloid 1-42 (Aβ1-42), 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 Aβ1-42, 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 Aβ1-42 levels (median = 393 pg/ml). Aβ1-42, 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 Aβ1-42 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 Aβ1-42 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, Aβ1-42 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.
AB - We investigated whether the cerebrospinal fluid (CSF) biomarkers beta-amyloid 1-42 (Aβ1-42), 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 Aβ1-42, 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 Aβ1-42 levels (median = 393 pg/ml). Aβ1-42, 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 Aβ1-42 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 Aβ1-42 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, Aβ1-42 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.
KW - Biomarkers
KW - Cerebro-vascular disorder
KW - Dementia
KW - Diagnosis
KW - White Matter Changes
UR - http://www.scopus.com/inward/record.url?scp=25644448985&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=25644448985&partnerID=8YFLogxK
U2 - 10.1016/j.jns.2005.05.016
DO - 10.1016/j.jns.2005.05.016
M3 - Article
C2 - 15990115
AN - SCOPUS:25644448985
VL - 237
SP - 83
EP - 88
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
IS - 1-2
ER -