Evaluation of CSF-tau and CSF-Abeta42 as diagnostic markers for Alzheimer disease in clinical practice

摘要: OBJECTIVE: To evaluate the diagnostic potential of cerebrospinal fluid (CSF) levels tau and beta-amyloid protein ending at amino acid 42 (Abeta42) as biomarkers for Alzheimer disease (AD) in clinical practice. DESIGN: A 1-year prospective study. SETTING: Community population-based sample all consecutive patients admitted investigation cognitive symptoms to Pitea River Valley Hospital, Pitea, Sweden. PATIENTS: total 241 with probable AD (n = 105), possible 58), vascular dementia 23), mild impairment 20), Lewy body 9), other neurological disorders 3), psychiatric 5) nondemented individuals 18). MAIN OUTCOME MEASURES: Cerebrospinal CSF-Abeta42 were assayed each week routine neurochemical analyses. Sensitivity specificity defined using regression line from 100 control subjects a multicenter Positive negative predictive values calculated different prevalence rates AD. RESULTS: We found increased CSF-tau decreased was 94% AD, 88% 75% impairment, whereas 100% 89% nondemented. Specificity lower (67%) mainly because low (48%) high levels. possessing ApoE epsilon4 allele, approaching 100%. At 45%, positive value 90% 95%. CONCLUSIONS: have so far been studied research settings, under conditions providing data on optimal performance. examined patient sample, assays run routine, giving figures closer true performance CSF-Abeta42. The greater than 90%. Therefore, these may role workup especially differentiate early normal aging disorders. (Less)