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Cerebrospinal fluid biomarker levels: Total tau and phosphorylated tau as markers for rate of progression in Alzheimer’s disease.

Wattmo, Carina LU ; Blennow, Kaj; Minthon, Lennart LU and Hansson, Oskar LU (2018) Advances in Alzheimer’s and Parkinson’s Therapies (AAT-AD/PD) Focus Meeting 2018
Abstract
Objectives: We investigated the potential associations between cerebrospinal fluid (CSF) levels of total tau (T-tau) and phosphorylated tau (P-tau), short-term response to cholinesterase inhibitor (ChEI) treatment, longitudinal outcome and progression rates in Alzheimer’s disease (AD).Methods: The Swedish Alzheimer Treatment Study (SATS) is a prospective, observational, multicentre study to assess long-term ChEI therapy in routine clinical practice. This presentation includes all 151 participants clinically diagnosed with AD, who underwent a lumbar puncture. Pathological levels of CSF biomarkers were defined as T-tau >100 ng/ml, P-tau >51 ng/ml and amyloid-beta 1-42 (Ab42) <209 ng/ml (xMAP technology). Cognitive, global,... (More)
Objectives: We investigated the potential associations between cerebrospinal fluid (CSF) levels of total tau (T-tau) and phosphorylated tau (P-tau), short-term response to cholinesterase inhibitor (ChEI) treatment, longitudinal outcome and progression rates in Alzheimer’s disease (AD).Methods: The Swedish Alzheimer Treatment Study (SATS) is a prospective, observational, multicentre study to assess long-term ChEI therapy in routine clinical practice. This presentation includes all 151 participants clinically diagnosed with AD, who underwent a lumbar puncture. Pathological levels of CSF biomarkers were defined as T-tau >100 ng/ml, P-tau >51 ng/ml and amyloid-beta 1-42 (Ab42) <209 ng/ml (xMAP technology). Cognitive, global, instrumental and basic activities of daily living (ADL) capacities at the start of ChEI treatment and semi-annually over 3 years were evaluated.Results: Seventy-three patients (48%) had normal T-tau and P-tau (Tau–), and 78 (52%) had pathological T-tau and/or P-tau (Tau+). All 151 individuals had pathological Ab42. Mean (95% confidence interval) instrumental ADL (IADL) decline/year for Tau– was 2.3 (1.6–3.0) points vs Tau+ 3.6 (2.8–4.5 points; P = 0.019). A linear relationship was observed between greater annual IADL deterioration and higher T-tau (rs = –0.233, P = 0.005) and P-tau (rs = –0.213, P = 0.010). No significant associations between tau and cognitive ability or basic ADL were detected. A higher percentage of globally improved/unchanged participants was exhibited in the Tau– group after 12 months (70% vs 48%, P = 0.014) and 30 months (53% vs 22%, P = 0.005) of ChEI therapy but not at other assessments. The proportion of 6-month responders to ChEI and the 3-year mean change in scores after initiation of treatment did not differ between the tau groups in any of the scales.Conclusions: A more-pronounced IADL and global, but not cognitive, rate of progression was found among ChEI-treated AD patients with pathological T-tau and/or P-tau, which might indicate worse prognosis in this group. (Less)
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organization
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Contribution to conference
publication status
published
subject
keywords
Alzheimer's disease, Cholinesterase inhibitors, Disease progression, CSF biomarkers, Tau
conference name
Advances in Alzheimer’s and Parkinson’s Therapies (AAT-AD/PD) Focus Meeting 2018
conference location
Turin, Italy
conference dates
2018-03-15 - 2018-03-18
language
English
LU publication?
yes
id
ee77c718-3462-4600-b93e-8f77b39e62e7
date added to LUP
2018-08-09 10:38:24
date last changed
2018-11-21 21:41:03
@misc{ee77c718-3462-4600-b93e-8f77b39e62e7,
  abstract     = {Objectives: We investigated the potential associations between cerebrospinal fluid (CSF) levels of total tau (T-tau) and phosphorylated tau (P-tau), short-term response to cholinesterase inhibitor (ChEI) treatment, longitudinal outcome and progression rates in Alzheimer’s disease (AD).Methods: The Swedish Alzheimer Treatment Study (SATS) is a prospective, observational, multicentre study to assess long-term ChEI therapy in routine clinical practice. This presentation includes all 151 participants clinically diagnosed with AD, who underwent a lumbar puncture. Pathological levels of CSF biomarkers were defined as T-tau &gt;100 ng/ml, P-tau &gt;51 ng/ml and amyloid-beta 1-42 (Ab42) &lt;209 ng/ml (xMAP technology). Cognitive, global, instrumental and basic activities of daily living (ADL) capacities at the start of ChEI treatment and semi-annually over 3 years were evaluated.Results: Seventy-three patients (48%) had normal T-tau and P-tau (Tau–), and 78 (52%) had pathological T-tau and/or P-tau (Tau+). All 151 individuals had pathological Ab42. Mean (95% confidence interval) instrumental ADL (IADL) decline/year for Tau– was 2.3 (1.6–3.0) points vs Tau+ 3.6 (2.8–4.5 points; P = 0.019). A linear relationship was observed between greater annual IADL deterioration and higher T-tau (rs = –0.233, P = 0.005) and P-tau (rs = –0.213, P = 0.010). No significant associations between tau and cognitive ability or basic ADL were detected. A higher percentage of globally improved/unchanged participants was exhibited in the Tau– group after 12 months (70% vs 48%, P = 0.014) and 30 months (53% vs 22%, P = 0.005) of ChEI therapy but not at other assessments. The proportion of 6-month responders to ChEI and the 3-year mean change in scores after initiation of treatment did not differ between the tau groups in any of the scales.Conclusions: A more-pronounced IADL and global, but not cognitive, rate of progression was found among ChEI-treated AD patients with pathological T-tau and/or P-tau, which might indicate worse prognosis in this group.},
  author       = {Wattmo, Carina and Blennow, Kaj and Minthon, Lennart and Hansson, Oskar},
  keyword      = {Alzheimer's disease,Cholinesterase inhibitors,Disease progression,CSF biomarkers,Tau},
  language     = {eng},
  location     = {Turin, Italy},
  title        = {Cerebrospinal fluid biomarker levels: Total tau and phosphorylated tau as markers for rate of progression in Alzheimer’s disease.},
  year         = {2018},
}