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Article Dans Une Revue Journal of Neurology, Neurosurgery and Psychiatry Année : 2010

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

Résumé

Background The clinical distinction between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) is sometimes difficult, particularly in mild cases. Although cerebrospinal fluid (CSF) markers such as Aβ42 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 at investigating whether CSF markers, in particular the level of Aβ38, can differentiate between mild AD and DLB. Methods In total 85 individuals were included after standardized diagnostic procedures: 30 diagnosed as probable AD, 23 probable DLB, 20 with probable Parkinson's disease dementia (PDD), and 12 non-demented controls subjects. CSF levels of Aβ38, Aβ40 and Aβ42 were determined using commercially available Ultra-Sensitive multi-array kit assay (MSD) for human Aβ peptides. Total-tau (T-tau) and Phosphorylated tau (P-Tau) were analysed using ELISA (Innotest). In addition, combinations (Aβ42/Aβ38, Aβ42/Aβ40, Aβ42/P-tau, and Aβ42/Aβ38/P-tau) were assessed. Results Significant between-group differences were found for all CSF measures, and all except Aβ40, Aβ42, and Aβ42/P-tau differed between AD and DLB. Aβ42/Aβ38 ratio was the measure that best discriminated between AD and DLB (AUC 0.781; p<0.005), with sensitivity 74% and specificity 77%. Conclusion This study suggests that the level of Aβ38 can potentially contribute in the diagnostic distinction between AD and DLB when combined with Aβ42. 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.
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Dates et versions

hal-00589971 , version 1 (03-05-2011)

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Ezra Mulugeta, Elisabet Londos, Clive Ballard, Guido Alves, Henrik Zetterberg, et al.. CSF Amyloid-beta 38 as a novel diagnostic marker for dementia with Lewy bodies. Journal of Neurology, Neurosurgery and Psychiatry, 2010, 82 (2), pp.160. ⟨10.1136/jnnp.2009.199398⟩. ⟨hal-00589971⟩

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