CSF and MRI markers independently contribute to the diagnosis of Alzheimer's disease

Schoonenboom, Niki S.M.; van der Flier, Wiesje M.; Blankenstein, Marinus A.; Bouwman, Femke H.; Van Kamp, Gerard J.; Barkhof, Frederik; Scheltens, Philip

doi:10.1016/j.neurobiolaging.2006.11.018

« Previous Next »Neurobiology of Aging
Volume 29, Issue 5 , Pages 669-675, May 2008

CSF and MRI markers independently contribute to the diagnosis of Alzheimer's disease

Niki S.M. Schoonenboom
- Department of Neurology, Alzheimer Center, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
- Corresponding author at: Department of Neurology, Alzheimer Center, VU University Medical Center, Postbus 7057, 1081 HV Amsterdam, The Netherlands. Tel.: +31 204440183/646022014; fax: +31 204440715.
Wiesje M. van der Flier
- Department of Neurology, Alzheimer Center, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
Marinus A. Blankenstein
- Department of Clinical Chemistry, Alzheimer Center, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
Femke H. Bouwman
- Department of Neurology, Alzheimer Center, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
Gerard J. Van Kamp
- Department of Neurology, Alzheimer Center, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
Frederik Barkhof
- Department of Radiology, Alzheimer Center, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
Philip Scheltens
- Department of Neurology, Alzheimer Center, VU University Medical Center, 1081 HV Amsterdam, The Netherlands

Received 12 May 2006; received in revised form 17 November 2006; accepted 25 November 2006. published online 08 January 2007.

Abstract

Background

Decreased amyloid β (1-42) (Aβ42) and increased (phosphorylated) tau in cerebrospinal fluid (CSF) are considered to be a reflection of plaques, tangles, and neuronal degeneration in Alzheimer's disease (AD). Atrophy of the medial temporal lobe (MTA) on magnetic resonance imaging (MRI) reflects neuronal loss in this area.

Objective

To compare diagnostic accuracy of CSF biomarkers and MTA in AD versus controls.

Methods

Aβ42, tau and tau phosphorylated at threonine 181 (Ptau-181) were measured in CSF from 61 AD patients and 32 controls by sandwich enzyme-linked immunosorbent assay. A CSF biomarker profile for AD was constructed. MTA was rated visually on MRI.

Results

When AD patients and controls were evaluated separately, no correlations were present between the CSF markers and MTA score. Both MTA and CSF biomarker profile were independently associated with the diagnosis AD (MTA: OR (95% CI)=28 (3–239); CSF biomarker profile: OR (95% CI)=57 (13–262)). Among individuals younger than 65 years old and without MTA 60% suffered AD, and the finding of an abnormal CSF biomarker profile was limited to AD patients only.

Conclusions

MTA and CSF biomarkers seem to be of incremental value for the diagnosis AD. CSF analysis is most sensitive in the absence of MTA, and especially among early-onset AD patients.

Keywords: Alzheimer's disease, CSF and MRI markers, Aβ42, tau and phosphorylated tau