The Cerebrospinal Fluid "Alzheimer Profile": Easily Said, but What Does It Mean?

Overview

Journal Alzheimers Dement

Specialties Neurology
Psychiatry

Date 2014 Apr 12

PMID 24721526

Citations 146

Authors

Flora H Duits

Charlotte E Teunissen

Femke H Bouwman

Pieter-Jelle Visser

Niklas Mattsson

Henrik Zetterberg

Kaj Blennow

Oskar Hansson

Lennart Minthon

Niels Andreasen

Jan Marcusson

Anders Wallin

Marcel Olde Rikkert

Magda Tsolaki

Lucilla Parnetti

Sanna-Kaisa Herukka

Harald Hampel

Mony J de Leon

Johannes Schroder

Dag Aarsland

Marinus A Blankenstein

Philip Scheltens

Wiesje M van der Flier

Affiliations

Soon will be listed here.

Abstract

Background: We aimed to identify the most useful definition of the "cerebrospinal fluid Alzheimer profile," based on amyloid-ß1-42 (Aβ42), total tau, and phosphorylated tau (p-tau), for diagnosis and prognosis of Alzheimer's disease (AD).

Methods: We constructed eight Alzheimer profiles with previously published combinations, including regression formulas and simple ratios. We compared their diagnostic accuracy and ability to predict dementia due to AD in 1385 patients from the Amsterdam Dementia Cohort. Results were validated in an independent cohort (n = 1442).

Results: Combinations outperformed individual biomarkers. Based on the sensitivity of the best performing regression formulas, cutoffs were chosen at 0.52 for the tau/Aβ42 ratio and 0.08 for the p-tau/Aβ42 ratio. Ratios performed similar to formulas (sensitivity, 91%-93%; specificity, 81%-84%). The same combinations best predicted cognitive decline in mild cognitive impairment patients. Validation confirmed these results, especially regarding the tau/Aβ42 ratio.

Conclusions: A tau/Aβ42 ratio of >0.52 constitutes a robust cerebrospinal fluid Alzheimer profile. We recommend using this ratio to combine biomarkers.

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