Till sidans topp

Sidansvarig: Webbredaktion
Sidan uppdaterades: 2012-09-11 15:12

Tipsa en vän
Utskriftsversion

CSF biomarkers and incipi… - Göteborgs universitet Till startsida
Webbkarta
Till innehåll Läs mer om hur kakor används på gu.se

CSF biomarkers and incipient Alzheimer disease in patients with mild cognitive impairment.

Artikel i vetenskaplig tidskrift
Författare Niklas Mattsson
Henrik Zetterberg
Oskar Hansson
Niels Andreasen
Lucilla Parnetti
Michael Jonsson
Sanna-Kaisa Herukka
Wiesje M van der Flier
Marinus A Blankenstein
Michael Ewers
Kenneth Rich
Elmar Kaiser
Marcel Verbeek
Magda Tsolaki
Ezra Mulugeta
Erik Rosén
Dag Aarsland
Pieter Jelle Visser
Johannes Schröder
Jan Marcusson
Mony de Leon
Harald Hampel
Philip Scheltens
Tuula Pirttilä
Anders Wallin
Maria Eriksdotter Jönhagen
Lennart Minthon
Bengt Winblad
Kaj Blennow
Publicerad i JAMA : the journal of the American Medical Association
Volym 302
Nummer/häfte 4
Sidor 385-93
ISSN 1538-3598
Publiceringsår 2009
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi
Sidor 385-93
Språk en
Länkar dx.doi.org/10.1001/jama.2009.1064
Ämnesord Adult, Aged, Aged, 80 and over, Alzheimer Disease, cerebrospinal fluid, diagnosis, Amyloid beta-Protein, cerebrospinal fluid, Biological Markers, cerebrospinal fluid, Cognition Disorders, cerebrospinal fluid, Cohort Studies, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Peptide Fragments, cerebrospinal fluid, Phosphothreonine, Sensitivity and Specificity, tau Proteins, cerebrospinal fluid, chemistry
Ämneskategorier Neurokemi, Psykiatri

Sammanfattning

CONTEXT: Small single-center studies have shown that cerebrospinal fluid (CSF) biomarkers may be useful to identify incipient Alzheimer disease (AD) in patients with mild cognitive impairment (MCI), but large-scale multicenter studies have not been conducted. OBJECTIVE: To determine the diagnostic accuracy of CSF beta-amyloid(1-42) (Abeta42), total tau protein (T-tau), and tau phosphorylated at position threonine 181 (P-tau) for predicting incipient AD in patients with MCI. DESIGN, SETTING, AND PARTICIPANTS: The study had 2 parts: a cross-sectional study involving patients with AD and controls to identify cut points, followed by a prospective cohort study involving patients with MCI, conducted 1990-2007. A total of 750 individuals with MCI, 529 with AD, and 304 controls were recruited by 12 centers in Europe and the United States. Individuals with MCI were followed up for at least 2 years or until symptoms had progressed to clinical dementia. MAIN OUTCOME MEASURES: Sensitivity, specificity, positive and negative likelihood ratios (LRs) of CSF Abeta42, T-tau, and P-tau for identifying incipient AD. RESULTS: During follow-up, 271 participants with MCI were diagnosed with AD and 59 with other dementias. The Abeta42 assay in particular had considerable intersite variability. Patients who developed AD had lower median Abeta42 (356; range, 96-1075 ng/L) and higher P-tau (81; range, 15-183 ng/L) and T-tau (582; range, 83-2174 ng/L) levels than MCI patients who did not develop AD during follow-up (579; range, 121-1420 ng/L for Abeta42; 53; range, 15-163 ng/L for P-tau; and 294; range, 31-2483 ng/L for T-tau, P < .001). The area under the receiver operating characteristic curve was 0.78 (95% confidence interval [CI], 0.75-0.82) for Abeta42, 0.76 (95% CI, 0.72-0.80) for P-tau, and 0.79 (95% CI, 0.76-0.83) for T-tau. Cut-offs with sensitivity set to 85% were defined in the AD and control groups and tested in the MCI group, where the combination of Abeta42/P-tau ratio and T-tau identified incipient AD with a sensitivity of 83% (95% CI, 78%-88%), specificity 72% (95% CI, 68%-76%), positive LR, 3.0 (95% CI, 2.5-3.4), and negative LR, 0.24 (95% CI, 0.21-0.28). The positive predictive value was 62% and the negative predictive value was 88%. CONCLUSIONS: This multicenter study found that CSF Abeta42, T-tau, and P-tau identify incipient AD with good accuracy, but less accurately than reported from single-center studies. Intersite assay variability highlights a need for standardization of analytical techniques and clinical procedures.

Sidansvarig: Webbredaktion|Sidan uppdaterades: 2012-09-11
Dela:

På Göteborgs universitet använder vi kakor (cookies) för att webbplatsen ska fungera på ett bra sätt för dig. Genom att surfa vidare godkänner du att vi använder kakor.  Vad är kakor?