Objective: Due to existent and forthcoming drug treatment of Alzheimer disease (AD), an increasing number of patients seek treatment very early in the course of the disease. They are diagnosed with mild cognitive impairment (MCI). As early treatment is considered having the best result in a progressive neurodegenerative disease as AD it would be of value to be able to disclose those patients who progress to AD. Biomarkers in the Cerebrospinal fluid (CSF) might be of diagnostic value in this early phase of the disease.
Design: Patients with diagnosed MCI who converted to AD with dementia at 1 year follow-up investigation
Materials and Methods: 44 patients with MCI and 32 controls. CSF total-tau (T-tau) (as a marker for neuronal degeneration), CSF phospho-tau (P-tau) (as a marker for hyperphosphorylation of tau and possibly for formation of neurofibrillary tangles), and CSF Ab42 (as a marker for Ab metabolism, and possible for formation of senile plaques) are considered as related to the central pathogenic processes in AD and were therefore analyzed.
Results: Of the MCI patients, 35/44 (79.5 %) had high CSF T-tau, 31/44 (70.4 %) high CSF P-tau, while 34/44 (77.3 %) had low CSF-Ab42 levels at baseline. We even calculated the positive likelihood ratio which was 8.45 for CSF T-tau, 7.49 for CSF P-tau, and 8.20 for CSF Ab42
Conclusion: Our findings suggest that the CSF-markers investigated in this study are abnormal before the onset of clinical dementia and that they, therefore, may help the clinician to identify MCI patients that will progress to AD. CSF diagnostic markers will be especially important when drugs with potential effects on the progression of AD (e.g. g-secretase inhibitors) will reach the clinical phase.
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