CSF biomarkers predict a more malignant outcome in Alzheimer disease.
Wallin, Å K LU ; Blennow, Kristina ; Zetterberg, H ; Londos, Elisabet LU ; Minthon, Lennart LU and Hansson, Oskar LU
(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}},
}