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Erlangen Score Predicts Cognitive and Neuroimaging Progression in Mild Cognitive Impairment Stage of Alzheimer's Disease

Journal article
Authors Tobias Skillbäck
J. Kornhuber
Kaj Blennow
Henrik Zetterberg
P. Lewczuk
Published in Journal of Alzheimers Disease
Volume 69
Issue 2
Pages 551-559
ISSN 1387-2877
Publication year 2019
Published at Institute of Neuroscience and Physiology
Pages 551-559
Language en
Keywords A beta(1-42), Alzheimer's disease, biomarkers, cerebrospinal fluid, Erlangen score, P-tau, T-tau, cerebrospinal-fluid, validation, biomarkers, Neurosciences & Neurology
Subject categories Neurosciences


Background: To alleviate the interpretation of the core Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers, amyloid beta(1-42) (A beta(42)), total tau (T-tau), and phosphorylated tau (P-tau), the Erlangen Score (ES) interpretation algorithm has been proposed. Objective: In this study, we aim to assess the predictive properties of the ES algorithm on cognitive and neuroimaging outcomes in mild cognitive impairment (MCI). Methods: All MCI subjects with an available baseline CSF sample from ADNI-1 were included (n = 193), and assigned an ES between 0 and 4 based on their baseline CSF biomarker profile. Structural magnetic resonance imaging brain scans and MMSE and ADAS-Cog scores were collected at up to 7 times in follow-up examinations. Results: We observed strong and significant correlations between the ES at baseline and neuroimaging and cognitive results with patients with neurochemically probable AD (ES = 4) progressing significantly (p <= 0.01) faster than those with a neurochemically improbable AD (ES = 0 or 1), and the subjects with neurochemically possible AD (ES = 2 or 3) in-between these two groups. Conclusion: This study further demonstrates the utility of the ES algorithm as a as a tool in predicting cognitive and imaging progression in MCI patients.

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