Added diagnostic value of CSF biomarkers in differential dementia diagnosis.

This study aimed to investigate whether cerebrospinal fluid (CSF) biomarkers could have helped the clinician in differential dementia diagnosis in case of clinically ambiguous diagnoses, as compared to autopsy-confirmed dementia diagnosis as gold standard. Twenty-two patients of our autopsy-confirmed dementia population totalling 157 patients had an ambiguous clinical diagnosis at CSF sampling and were included in statistical analysis. CSF levels of β-amyloid peptide (Aβ(1-42)), total tau protein (T-tau) and tau phosphorylated at threonine 181 (P-tau(181P)) were determined. A biomarker-based model was applied to discriminate between AD and NON-AD dementias. AD and NON-AD patients showed no significant differences in Aβ(1-42) and T-tau concentrations, whereas P-tau(181P) concentrations were significantly higher in AD compared to NON-AD patients. The biomarker-based diagnostic model correctly classified 18 of 22 (82%) patients with clinically ambiguous diagnoses. Using a biomarker-based model in patients with clinically ambiguous diagnoses, a correct diagnosis would have been established in the majority of autopsy-confirmed AD and NON-AD cases, indicating that biomarkers have an added diagnostic value in cases with ambiguous clinical diagnoses.

Le Bastard N ，Martin JJ ，Vanmechelen E ，Vanderstichele H ，De Deyn PP ，Engelborghs S ... -  《-》

Diagnostic performance of a CSF-biomarker panel in autopsy-confirmed dementia.

Engelborghs S ，De Vreese K ，Van de Casteele T ，Vanderstichele H ，Van Everbroeck B ，Cras P ，Martin JJ ，Vanmechelen E ，De Deyn PP ... -  《-》

Improved discrimination of autopsy-confirmed Alzheimer's disease (AD) from non-AD dementias using CSF P-tau(181P).

Koopman K ，Le Bastard N ，Martin JJ ，Nagels G ，De Deyn PP ，Engelborghs S ... -  《-》

Assessment of cerebrospinal fluid (CSF) beta-amyloid (1-42), phosphorylated tau (ptau-181) and total Tau protein in patients with Alzheimer's disease (AD) and other dementia at Siriraj Hospital, Thailand.

Thaweepoksomboon J ，Senanarong V ，Poungvarin N ，Chakorn T ，Siwasariyanon N ，Washirutmangkur L ，Udompunthuruk S ... -  《-》

Diagnostic impact of CSF biomarkers in a local hospital memory clinic.

CSF biomarkers amyloid-beta 1-42 (Abeta42), total tau (tau) and tau phosphorylated at threonine 181 (ptau-181) are useful diagnostic markers for Alzheimer's disease (AD). We examined the impact of these biomarkers in the diagnostic process in a non-academic memory clinic. One hundred and nine patients with available CSF were included from the local hospital memory clinic. Initially, patients were clinically diagnosed, and the clinician indicated their confidence in the diagnosis. Next the CSF results were presented, and the clinician re-evaluated his initial diagnosis. The main outcomes were changes in initial diagnosis and diagnostic confidence. Forty-seven patients were initially diagnosed with AD, 26 were diagnosed with another type of dementia, 18 were diagnosed with mild cognitive impairment, and 18 received a non-dementia diagnosis. All biomarkers distinguished between AD and non-dementia (p < 0.01); tau and ptau-181 also distinguished AD from other types of dementia (p < 0.001). After CSF biomarker levels were revealed, 11 diagnoses changed. In 31% of the diagnoses, the clinician gained confidence, while in 10% confidence decreased. We found that knowledge of CSF biomarker profiles changed the diagnosis in 10% of the cases, and confidence in the diagnosis increased for one third of the patients.

Kester MI ，Boelaarts L ，Bouwman FH ，Vogels RL ，Groot ER ，van Elk EJ ，Blankenstein MA ，van der Flier WM ，Scheltens P ... -  《-》