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The role of CSF biomarkers in the diagnostic work-up of mixed vascular-degenerative dementia.
J Neurol Sci 2012; 322(1-2):197-9JN

Abstract

Low average specificity levels of 48% for clinical diagnosis of possible Alzheimer's disease (AD) reflect the overlap of clinical profiles between AD and non-AD dementias. Should diagnostic errors occur, they most likely involve one of the other primary dementias, mixed pathologies that include a vascular component, or uncertainties that are associated with early diagnosis. Vascular dementia (VaD) is overdiagnosed when a routine brain MRI or CT scan is used in the context of standard clinical diagnostic criteria, meanwhile denying significant neurodegenerative co-pathology. A promising approach for increasing diagnostic accuracy is the use of biochemical markers (biomarkers) that are present in the cerebrospinal fluid (CSF). The CSF biomarkers β-amyloid protein of 42 amino acids (Aβ(1-42)), total tau protein (T-tau), and tau phosphorylated at threonine 181 (P-tau(181P)) are well validated. A combined analysis of these biomarkers is of help to discriminate AD from non-AD dementias (including VaD), reaching sensitivity and specificity levels that exceed 80%. Moreover, the added value of CSF biomarkers could lie within those cases in which the clinical diagnostic work-up is not able to discriminate between AD or a non-AD dementia. In case of doubt between VaD or mixed AD-VaD pathology in dementia patients, the determination of CSF Aβ(1-42), T-tau and P-tau(181P) levels is of help to confirm or exclude the AD component in the pathophysiology of the dementia syndrome.

Authors+Show Affiliations

Reference Centre for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, BE-2610 Antwerp, Belgium. Sebastiaan.Engelborghs@ua.ac.beNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22947896

Citation

Engelborghs, Sebastiaan, and Nathalie Le Bastard. "The Role of CSF Biomarkers in the Diagnostic Work-up of Mixed Vascular-degenerative Dementia." Journal of the Neurological Sciences, vol. 322, no. 1-2, 2012, pp. 197-9.
Engelborghs S, Le Bastard N. The role of CSF biomarkers in the diagnostic work-up of mixed vascular-degenerative dementia. J Neurol Sci. 2012;322(1-2):197-9.
Engelborghs, S., & Le Bastard, N. (2012). The role of CSF biomarkers in the diagnostic work-up of mixed vascular-degenerative dementia. Journal of the Neurological Sciences, 322(1-2), pp. 197-9. doi:10.1016/j.jns.2012.08.003.
Engelborghs S, Le Bastard N. The Role of CSF Biomarkers in the Diagnostic Work-up of Mixed Vascular-degenerative Dementia. J Neurol Sci. 2012 Nov 15;322(1-2):197-9. PubMed PMID: 22947896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of CSF biomarkers in the diagnostic work-up of mixed vascular-degenerative dementia. AU - Engelborghs,Sebastiaan, AU - Le Bastard,Nathalie, Y1 - 2012/09/02/ PY - 2012/02/13/received PY - 2012/08/07/accepted PY - 2012/9/6/entrez PY - 2012/9/6/pubmed PY - 2013/4/12/medline SP - 197 EP - 9 JF - Journal of the neurological sciences JO - J. Neurol. Sci. VL - 322 IS - 1-2 N2 - Low average specificity levels of 48% for clinical diagnosis of possible Alzheimer's disease (AD) reflect the overlap of clinical profiles between AD and non-AD dementias. Should diagnostic errors occur, they most likely involve one of the other primary dementias, mixed pathologies that include a vascular component, or uncertainties that are associated with early diagnosis. Vascular dementia (VaD) is overdiagnosed when a routine brain MRI or CT scan is used in the context of standard clinical diagnostic criteria, meanwhile denying significant neurodegenerative co-pathology. A promising approach for increasing diagnostic accuracy is the use of biochemical markers (biomarkers) that are present in the cerebrospinal fluid (CSF). The CSF biomarkers β-amyloid protein of 42 amino acids (Aβ(1-42)), total tau protein (T-tau), and tau phosphorylated at threonine 181 (P-tau(181P)) are well validated. A combined analysis of these biomarkers is of help to discriminate AD from non-AD dementias (including VaD), reaching sensitivity and specificity levels that exceed 80%. Moreover, the added value of CSF biomarkers could lie within those cases in which the clinical diagnostic work-up is not able to discriminate between AD or a non-AD dementia. In case of doubt between VaD or mixed AD-VaD pathology in dementia patients, the determination of CSF Aβ(1-42), T-tau and P-tau(181P) levels is of help to confirm or exclude the AD component in the pathophysiology of the dementia syndrome. SN - 1878-5883 UR - https://www.unboundmedicine.com/medline/citation/22947896/The_role_of_CSF_biomarkers_in_the_diagnostic_work_up_of_mixed_vascular_degenerative_dementia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(12)00432-7 DB - PRIME DP - Unbound Medicine ER -