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CSF amyloid beta 38 as a novel diagnostic marker for dementia with Lewy bodies

Mulugeta, Ezra; Londos, Elisabet LU ; Ballard, Clive; Alves, Guido; Zetterberg, Henrik; Blennow, Kaj; Skogseth, Ragnhild; Minthon, Lennart LU and Aarsland, Dag (2011) In Journal of Neurology, Neurosurgery and Psychiatry 82(2). p.160-164
Abstract
Background The clinical distinction between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) is sometimes difficult, particularly in mild cases. Although CSF markers such as amyloid beta 42 (A beta 42) and P-tau can distinguish between AD and normal controls, their ability to distinguish between AD and DLB is not adequate. Objective This study aims to investigate whether CSF markers, in particular levels of A beta 38, can differentiate between mild AD and DLB. Methods 85 individuals were included after standardised diagnostic procedures: 30 diagnosed as probable AD, 23 probable DLB, 20 probable Parkinson's disease dementia and 12 non-demented control subjects. CSF levels of A beta 38, A beta 40 and A beta 42 were determined... (More)
Background The clinical distinction between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) is sometimes difficult, particularly in mild cases. Although CSF markers such as amyloid beta 42 (A beta 42) and P-tau can distinguish between AD and normal controls, their ability to distinguish between AD and DLB is not adequate. Objective This study aims to investigate whether CSF markers, in particular levels of A beta 38, can differentiate between mild AD and DLB. Methods 85 individuals were included after standardised diagnostic procedures: 30 diagnosed as probable AD, 23 probable DLB, 20 probable Parkinson's disease dementia and 12 non-demented control subjects. CSF levels of A beta 38, A beta 40 and A beta 42 were determined using commercially available ultra-sensitive multi-array kit assay (MSD) for human A beta peptides. Total tau (T-tau) and phosphorylated tau (P-tau) were analysed using ELISA (Innotest). In addition, combinations (A beta 42/A beta 38, A beta 42/A beta 40, A beta 42/P-tau and A beta 42/A beta 38/P-tau) were assessed. Results Significant between group differences were found for all CSF measures, and all except A beta 40, A beta 42 and A beta 42/P-tau differed between AD and DLB. The A beta 42/A beta 38 ratio was the measure that best discriminated between AD and DLB (AUC 0.765; p<0.005), with a sensitivity of 78% and a specificity of 67%. Conclusion This study suggests that the level of A beta 38 can potentially contribute in the diagnostic distinction between AD and DLB when combined with A beta 42. Single measures had low diagnostic accuracy, suggesting that developing a panel of markers is the most promising strategy. Studies with independent and larger samples and a priori cut-offs are needed to test this hypothesis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Neurology, Neurosurgery and Psychiatry
volume
82
issue
2
pages
160 - 164
publisher
BMJ Publishing Group
external identifiers
  • wos:000285920600010
  • scopus:78751521471
ISSN
1468-330X
DOI
10.1136/jnnp.2009.199398
language
English
LU publication?
yes
id
c9db9db7-8435-4bb3-9907-2ef98aea6397 (old id 1790716)
date added to LUP
2011-03-02 13:16:39
date last changed
2017-11-19 03:49:44
@article{c9db9db7-8435-4bb3-9907-2ef98aea6397,
  abstract     = {Background The clinical distinction between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) is sometimes difficult, particularly in mild cases. Although CSF markers such as amyloid beta 42 (A beta 42) and P-tau can distinguish between AD and normal controls, their ability to distinguish between AD and DLB is not adequate. Objective This study aims to investigate whether CSF markers, in particular levels of A beta 38, can differentiate between mild AD and DLB. Methods 85 individuals were included after standardised diagnostic procedures: 30 diagnosed as probable AD, 23 probable DLB, 20 probable Parkinson's disease dementia and 12 non-demented control subjects. CSF levels of A beta 38, A beta 40 and A beta 42 were determined using commercially available ultra-sensitive multi-array kit assay (MSD) for human A beta peptides. Total tau (T-tau) and phosphorylated tau (P-tau) were analysed using ELISA (Innotest). In addition, combinations (A beta 42/A beta 38, A beta 42/A beta 40, A beta 42/P-tau and A beta 42/A beta 38/P-tau) were assessed. Results Significant between group differences were found for all CSF measures, and all except A beta 40, A beta 42 and A beta 42/P-tau differed between AD and DLB. The A beta 42/A beta 38 ratio was the measure that best discriminated between AD and DLB (AUC 0.765; p&lt;0.005), with a sensitivity of 78% and a specificity of 67%. Conclusion This study suggests that the level of A beta 38 can potentially contribute in the diagnostic distinction between AD and DLB when combined with A beta 42. Single measures had low diagnostic accuracy, suggesting that developing a panel of markers is the most promising strategy. Studies with independent and larger samples and a priori cut-offs are needed to test this hypothesis.},
  author       = {Mulugeta, Ezra and Londos, Elisabet and Ballard, Clive and Alves, Guido and Zetterberg, Henrik and Blennow, Kaj and Skogseth, Ragnhild and Minthon, Lennart and Aarsland, Dag},
  issn         = {1468-330X},
  language     = {eng},
  number       = {2},
  pages        = {160--164},
  publisher    = {BMJ Publishing Group},
  series       = {Journal of Neurology, Neurosurgery and Psychiatry},
  title        = {CSF amyloid beta 38 as a novel diagnostic marker for dementia with Lewy bodies},
  url          = {http://dx.doi.org/10.1136/jnnp.2009.199398},
  volume       = {82},
  year         = {2011},
}