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Clinical Experience with Cerebrospinal Fluid A?42, Total and Phosphorylated Tau in the Evaluation of 1,016 Individuals for Suspected Dementia.


ABSTRACT: BACKGROUND:Elevated total tau (tTau), 181-phosphorylated phosphorylated tau (pTau), and low amyloid-?42 (A?42) in cerebrospinal fluid (CSF) represent a diagnostic biomarker for Alzheimer's disease (AD). OBJECTIVE:The goal was to determine the overall accuracy of CSF A?42, tTau, pTau, and the A?42/total tau index (ATI) in a non-research, clinical setting for the diagnosis of AD. METHODS:From medical records in 1,016 patients that had CSF studies for dementia over a 12-year period (2005 to 2017), we calculated the sensitivity and specificity of CSF A?42, tTau, and pTau and the ATI in relation to the final clinical diagnosis. RESULTS:Compared with non-demented patients and patients with other dementias or mild cognitive impairment (MCI), the sensitivity and specificity of the recommended ATI and pTau cut-offs (ATI?61 pg/ml) for the diagnosis of AD were 0.88 and 0.72, respectively. Similar results were obtained comparing AD with non-demented patients only (0.88, 0.82) and AD with other types of dementia (0.81, 0.77). A subgroup of patients with presumed normal pressure hydrocephalus (n?=?154) were biopsied at the time of shunt placement. Using the pathological manifestations of AD as the standard, the sensitivity was 0.83 while the specificity was 0.72. CONCLUSIONS:In a non-research setting, CSF biomarkers for AD showed a high sensitivity in accordance with previous studies, but modest specificity differentiating AD from other types of dementia or MCI. This study of unselected patients provides a valid and realistic assessment of the diagnostic accuracy of these CSF biomarkers in clinical practice.

SUBMITTER: Tariciotti L 

PROVIDER: S-EPMC6218126 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Clinical Experience with Cerebrospinal Fluid Aβ42, Total and Phosphorylated Tau in the Evaluation of 1,016 Individuals for Suspected Dementia.

Tariciotti Leonardo L   Casadei Matthew M   Honig Lawrence S LS   Teich Andrew F AF   McKhann Ii Guy M GM   Tosto Giuseppe G   Mayeux Richard R  

Journal of Alzheimer's disease : JAD 20180101 4


<h4>Background</h4>Elevated total tau (tTau), 181-phosphorylated phosphorylated tau (pTau), and low amyloid-β42 (Aβ42) in cerebrospinal fluid (CSF) represent a diagnostic biomarker for Alzheimer's disease (AD).<h4>Objective</h4>The goal was to determine the overall accuracy of CSF Aβ42, tTau, pTau, and the Aβ42/total tau index (ATI) in a non-research, clinical setting for the diagnosis of AD.<h4>Methods</h4>From medical records in 1,016 patients that had CSF studies for dementia over a 12-year p  ...[more]

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