CSF biomarkers predict a more malignant outcome in Alzheimer disease.
(2010) In Neurology 74(19). p.1531-1537- Abstract
- OBJECTIVE: To investigate if patterns of CSF biomarkers (T-tau, P-tau, and Abeta42) can predict cognitive progression, outcome of cholinesterase inhibitor (ChEI) treatment, and mortality in Alzheimer disease (AD). METHODS: We included outpatients with AD (n = 151) from a prospective treatment study with ChEI. At baseline, patients underwent cognitive assessments and lumbar puncture. The patients were assessed longitudinally. The 5-year survival rate was evaluated. CSF-Abeta42, T-tau, and P-tau were analyzed at baseline. K-means cluster analysis including the 3 CSF biomarkers was carried out. RESULTS: Cluster 1 contained 87 patients with low levels of Abeta42 and relatively low levels of T-tau and P-tau. Cluster 2 contained 52 patients with... (More)
- OBJECTIVE: To investigate if patterns of CSF biomarkers (T-tau, P-tau, and Abeta42) can predict cognitive progression, outcome of cholinesterase inhibitor (ChEI) treatment, and mortality in Alzheimer disease (AD). METHODS: We included outpatients with AD (n = 151) from a prospective treatment study with ChEI. At baseline, patients underwent cognitive assessments and lumbar puncture. The patients were assessed longitudinally. The 5-year survival rate was evaluated. CSF-Abeta42, T-tau, and P-tau were analyzed at baseline. K-means cluster analysis including the 3 CSF biomarkers was carried out. RESULTS: Cluster 1 contained 87 patients with low levels of Abeta42 and relatively low levels of T-tau and P-tau. Cluster 2 contained 52 patients with low levels of Abeta42 and intermediate levels of T-tau and P-tau. Cluster 3 contained 12 patients with low levels of Abeta42 and very high levels of CSF T-tau and P-tau. There were no differences between the clusters regarding age, gender, years of education, baseline instrumental activities of daily living, or APOE genotype. Even though there was no difference between cluster 3 and the other clusters in disease duration or global rating, the patients in cluster 3 performed worse on cognitive tests already at baseline. Patients in cluster 3 exhibited a very poor outcome of ChEI treatment. Finally, cognition deteriorated faster over time and the mortality rate was substantially increased in cluster 3. CONCLUSION: A subgroup of patients with Alzheimer disease with extreme levels of CSF biomarkers exhibits worse clinical outcomes over time, including faster progression of cognitive deficits, no response to ChEI treatment, and a higher mortality. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1610350
- author
- Wallin, Å K LU ; Blennow, Kristina ; Zetterberg, H ; Londos, Elisabet LU ; Minthon, Lennart LU and Hansson, Oskar LU
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Neurology
- volume
- 74
- issue
- 19
- pages
- 1531 - 1537
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- wos:000277477000009
- pmid:20458070
- scopus:77952202260
- ISSN
- 1526-632X
- DOI
- 10.1212/WNL.0b013e3181dd4dd8
- language
- English
- LU publication?
- yes
- id
- d1e0d492-6cd0-4c8e-97d1-a9eece2219df (old id 1610350)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/20458070?dopt=Abstract
- date added to LUP
- 2016-04-04 09:18:14
- date last changed
- 2022-04-23 19:57:08
@article{d1e0d492-6cd0-4c8e-97d1-a9eece2219df, abstract = {{OBJECTIVE: To investigate if patterns of CSF biomarkers (T-tau, P-tau, and Abeta42) can predict cognitive progression, outcome of cholinesterase inhibitor (ChEI) treatment, and mortality in Alzheimer disease (AD). METHODS: We included outpatients with AD (n = 151) from a prospective treatment study with ChEI. At baseline, patients underwent cognitive assessments and lumbar puncture. The patients were assessed longitudinally. The 5-year survival rate was evaluated. CSF-Abeta42, T-tau, and P-tau were analyzed at baseline. K-means cluster analysis including the 3 CSF biomarkers was carried out. RESULTS: Cluster 1 contained 87 patients with low levels of Abeta42 and relatively low levels of T-tau and P-tau. Cluster 2 contained 52 patients with low levels of Abeta42 and intermediate levels of T-tau and P-tau. Cluster 3 contained 12 patients with low levels of Abeta42 and very high levels of CSF T-tau and P-tau. There were no differences between the clusters regarding age, gender, years of education, baseline instrumental activities of daily living, or APOE genotype. Even though there was no difference between cluster 3 and the other clusters in disease duration or global rating, the patients in cluster 3 performed worse on cognitive tests already at baseline. Patients in cluster 3 exhibited a very poor outcome of ChEI treatment. Finally, cognition deteriorated faster over time and the mortality rate was substantially increased in cluster 3. CONCLUSION: A subgroup of patients with Alzheimer disease with extreme levels of CSF biomarkers exhibits worse clinical outcomes over time, including faster progression of cognitive deficits, no response to ChEI treatment, and a higher mortality.}}, author = {{Wallin, Å K and Blennow, Kristina and Zetterberg, H and Londos, Elisabet and Minthon, Lennart and Hansson, Oskar}}, issn = {{1526-632X}}, language = {{eng}}, number = {{19}}, pages = {{1531--1537}}, publisher = {{Lippincott Williams & Wilkins}}, series = {{Neurology}}, title = {{CSF biomarkers predict a more malignant outcome in Alzheimer disease.}}, url = {{http://dx.doi.org/10.1212/WNL.0b013e3181dd4dd8}}, doi = {{10.1212/WNL.0b013e3181dd4dd8}}, volume = {{74}}, year = {{2010}}, }