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CSF biomarkers predict a more malignant outcome in Alzheimer disease.
Neurology 2010; 74(19):1531-7Neur

Abstract

OBJECTIVE

To investigate if patterns of CSF biomarkers (T-tau, P-tau, and Abeta42) can predict cognitive progression, outcome of cholinesterase inhibitor (ChEI) treatment, and mortality in Alzheimer disease (AD).

METHODS

We included outpatients with AD (n = 151) from a prospective treatment study with ChEI. At baseline, patients underwent cognitive assessments and lumbar puncture. The patients were assessed longitudinally. The 5-year survival rate was evaluated. CSF-Abeta42, T-tau, and P-tau were analyzed at baseline. K-means cluster analysis including the 3 CSF biomarkers was carried out.

RESULTS

Cluster 1 contained 87 patients with low levels of Abeta42 and relatively low levels of T-tau and P-tau. Cluster 2 contained 52 patients with low levels of Abeta42 and intermediate levels of T-tau and P-tau. Cluster 3 contained 12 patients with low levels of Abeta42 and very high levels of CSF T-tau and P-tau. There were no differences between the clusters regarding age, gender, years of education, baseline instrumental activities of daily living, or APOE genotype. Even though there was no difference between cluster 3 and the other clusters in disease duration or global rating, the patients in cluster 3 performed worse on cognitive tests already at baseline. Patients in cluster 3 exhibited a very poor outcome of ChEI treatment. Finally, cognition deteriorated faster over time and the mortality rate was substantially increased in cluster 3.

CONCLUSION

A subgroup of patients with Alzheimer disease with extreme levels of CSF biomarkers exhibits worse clinical outcomes over time, including faster progression of cognitive deficits, no response to ChEI treatment, and a higher mortality.

Authors+Show Affiliations

Malmö University Hospital, SE-205 02 Malmö, Sweden. asa.k.wallin@skane.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20458070

Citation

Wallin, A K., et al. "CSF Biomarkers Predict a More Malignant Outcome in Alzheimer Disease." Neurology, vol. 74, no. 19, 2010, pp. 1531-7.
Wallin AK, Blennow K, Zetterberg H, et al. CSF biomarkers predict a more malignant outcome in Alzheimer disease. Neurology. 2010;74(19):1531-7.
Wallin, A. K., Blennow, K., Zetterberg, H., Londos, E., Minthon, L., & Hansson, O. (2010). CSF biomarkers predict a more malignant outcome in Alzheimer disease. Neurology, 74(19), pp. 1531-7. doi:10.1212/WNL.0b013e3181dd4dd8.
Wallin AK, et al. CSF Biomarkers Predict a More Malignant Outcome in Alzheimer Disease. Neurology. 2010 May 11;74(19):1531-7. PubMed PMID: 20458070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CSF biomarkers predict a more malignant outcome in Alzheimer disease. AU - Wallin,A K, AU - Blennow,K, AU - Zetterberg,H, AU - Londos,E, AU - Minthon,L, AU - Hansson,O, PY - 2010/5/12/entrez PY - 2010/5/12/pubmed PY - 2010/7/2/medline SP - 1531 EP - 7 JF - Neurology JO - Neurology VL - 74 IS - 19 N2 - OBJECTIVE: To investigate if patterns of CSF biomarkers (T-tau, P-tau, and Abeta42) can predict cognitive progression, outcome of cholinesterase inhibitor (ChEI) treatment, and mortality in Alzheimer disease (AD). METHODS: We included outpatients with AD (n = 151) from a prospective treatment study with ChEI. At baseline, patients underwent cognitive assessments and lumbar puncture. The patients were assessed longitudinally. The 5-year survival rate was evaluated. CSF-Abeta42, T-tau, and P-tau were analyzed at baseline. K-means cluster analysis including the 3 CSF biomarkers was carried out. RESULTS: Cluster 1 contained 87 patients with low levels of Abeta42 and relatively low levels of T-tau and P-tau. Cluster 2 contained 52 patients with low levels of Abeta42 and intermediate levels of T-tau and P-tau. Cluster 3 contained 12 patients with low levels of Abeta42 and very high levels of CSF T-tau and P-tau. There were no differences between the clusters regarding age, gender, years of education, baseline instrumental activities of daily living, or APOE genotype. Even though there was no difference between cluster 3 and the other clusters in disease duration or global rating, the patients in cluster 3 performed worse on cognitive tests already at baseline. Patients in cluster 3 exhibited a very poor outcome of ChEI treatment. Finally, cognition deteriorated faster over time and the mortality rate was substantially increased in cluster 3. CONCLUSION: A subgroup of patients with Alzheimer disease with extreme levels of CSF biomarkers exhibits worse clinical outcomes over time, including faster progression of cognitive deficits, no response to ChEI treatment, and a higher mortality. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/20458070/CSF_biomarkers_predict_a_more_malignant_outcome_in_Alzheimer_disease_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=20458070 DB - PRIME DP - Unbound Medicine ER -