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CSF tau, Aβ42, and MHPG differentiate dementia with Lewy bodies from Alzheimer's disease.
J Alzheimers Dis 2011; 27(2):377-84JA

Abstract

Differentiating dementia with Lewy bodies (DLB) from Alzheimer's Disease (AD) can be difficult because of the substantial overlap in clinical features. Since deficits in serotonergic and dopaminergic pathways seem more pronounced in DLB patients, we investigated whether cerebrospinal fluid (CSF) analysis of neurotransmitter metabolites, in addition to brain-specific proteins, may improve the differentiation between DLB and AD. We retrospectively compared CSF concentrations of the neurotransmitter metabolites homovanillic acid (HVA), 5-hydroxyindolacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) and the brain-specific proteins total tau (t-tau), phosphorylated tau protein (p-tau), and amyloid-β42 (Aβ42) in 45 patients with AD (mean age 71.6 years; 34 (76%) men; 44 probable AD, 1 definite) and 23 patients with DLB (mean age 71.6 years; 18 (78%) men; 6 possible DLB, 16 probable, 1 definite). The concentrations of all neurotransmitter metabolites, as well as those for t-tau and p-tau protein, were significantly lower in DLB compared to AD, irrespective of the diagnostic certainty (i.e., possible or probable). The currently used combination of Aβ42, p-tau, and t-tau yielded a sensitivity of 92.9% and a specificity of 90%. The addition of MHPG resulted in an increased sensitivity of 97.6% and a specificity of 95% for the discrimination between DLB and AD. In conclusion, the combination of MHPG and the brain specific proteins t-tau, p-tau, and Aβ42 in CSF were associated with the clinical diagnosis of DLB and discriminated between AD and DLB with high diagnostic accuracy, suggesting this combination as a potential biomarker for DLB.

Authors+Show Affiliations

Radboud University Nijmegen Medical Centre, Department of Neurology and Parkinson Center Nijmegen, Nijmegen, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

21841257

Citation

Aerts, Marjolein B., et al. "CSF Tau, Aβ42, and MHPG Differentiate Dementia With Lewy Bodies From Alzheimer's Disease." Journal of Alzheimer's Disease : JAD, vol. 27, no. 2, 2011, pp. 377-84.
Aerts MB, Esselink RA, Claassen JA, et al. CSF tau, Aβ42, and MHPG differentiate dementia with Lewy bodies from Alzheimer's disease. J Alzheimers Dis. 2011;27(2):377-84.
Aerts, M. B., Esselink, R. A., Claassen, J. A., Abdo, W. F., Bloem, B. R., & Verbeek, M. M. (2011). CSF tau, Aβ42, and MHPG differentiate dementia with Lewy bodies from Alzheimer's disease. Journal of Alzheimer's Disease : JAD, 27(2), pp. 377-84. doi:10.3233/JAD-2011-110482.
Aerts MB, et al. CSF Tau, Aβ42, and MHPG Differentiate Dementia With Lewy Bodies From Alzheimer's Disease. J Alzheimers Dis. 2011;27(2):377-84. PubMed PMID: 21841257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CSF tau, Aβ42, and MHPG differentiate dementia with Lewy bodies from Alzheimer's disease. AU - Aerts,Marjolein B, AU - Esselink,Rianne A J, AU - Claassen,Jugen A H R, AU - Abdo,Wilson Farid, AU - Bloem,Bastiaan R, AU - Verbeek,Marcel M, PY - 2011/8/16/entrez PY - 2011/8/16/pubmed PY - 2012/8/17/medline SP - 377 EP - 84 JF - Journal of Alzheimer's disease : JAD JO - J. Alzheimers Dis. VL - 27 IS - 2 N2 - Differentiating dementia with Lewy bodies (DLB) from Alzheimer's Disease (AD) can be difficult because of the substantial overlap in clinical features. Since deficits in serotonergic and dopaminergic pathways seem more pronounced in DLB patients, we investigated whether cerebrospinal fluid (CSF) analysis of neurotransmitter metabolites, in addition to brain-specific proteins, may improve the differentiation between DLB and AD. We retrospectively compared CSF concentrations of the neurotransmitter metabolites homovanillic acid (HVA), 5-hydroxyindolacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) and the brain-specific proteins total tau (t-tau), phosphorylated tau protein (p-tau), and amyloid-β42 (Aβ42) in 45 patients with AD (mean age 71.6 years; 34 (76%) men; 44 probable AD, 1 definite) and 23 patients with DLB (mean age 71.6 years; 18 (78%) men; 6 possible DLB, 16 probable, 1 definite). The concentrations of all neurotransmitter metabolites, as well as those for t-tau and p-tau protein, were significantly lower in DLB compared to AD, irrespective of the diagnostic certainty (i.e., possible or probable). The currently used combination of Aβ42, p-tau, and t-tau yielded a sensitivity of 92.9% and a specificity of 90%. The addition of MHPG resulted in an increased sensitivity of 97.6% and a specificity of 95% for the discrimination between DLB and AD. In conclusion, the combination of MHPG and the brain specific proteins t-tau, p-tau, and Aβ42 in CSF were associated with the clinical diagnosis of DLB and discriminated between AD and DLB with high diagnostic accuracy, suggesting this combination as a potential biomarker for DLB. SN - 1875-8908 UR - https://www.unboundmedicine.com/medline/citation/21841257/CSF_tau_Aβ42_and_MHPG_differentiate_dementia_with_Lewy_bodies_from_Alzheimer's_disease_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JAD-2011-110482 DB - PRIME DP - Unbound Medicine ER -