Fellgiebel Andreas, Siessmeier Thomas, Scheurich Armin, Winterer Georg, Bartenstein Peter, Schmidt Lutz G, Müller Matthias J
Department of Psychiatry, University of Mainz, Mainz, Germany.
Biol Psychiatry. 2004 Aug 15;56(4):279-83. doi: 10.1016/j.biopsych.2004.05.014.
Mild cognitive impairment is considered to be a transitional stage between normal aging and dementia. Phosphorylated tau protein in cerebrospinal fluid and even more decrements of cerebral glucose metabolism in parietal, temporal, or cingulate regions have shown favorable specificity for the diagnosis of Alzheimer dementia and could be useful supplementary tools to determine Alzheimer pathology in early stages.
We measured cerebrospinal fluid tau phosphorylated at threonine 181 protein, cerebrospinal fluid total tau, and cerebral glucose metabolism using 18F-fluoro-2-deoxy-D-glucose positron emission tomography in 16 patients with mild cognitive impairment and age-matched control subjects.
Alzheimer-typical patterns of cerebral glucose metabolism were significantly related to elevated phosphorylated tau levels (p =.009) but not to elevated total tau levels. In six of seven mild cognitive impairment patients with increased phosphorylated tau concentrations, Alzheimer disease-typical positron emission tomography patterns were found. Phosphorylated tau measurement separated patients with and without Alzheimer disease-typical positron emission tomography findings with a sensitivity of 85.7% and a specificity of 88.9%.
Unlike total tau levels, elevated phosphorylated tau levels were strictly related to Alzheimer-typical patterns of cerebral glucose metabolism in mild cognitive impairment patients. The results can be interpreted as validation of phosphorylated tau measurements for detecting Alzheimer disease in mild cognitive impairment patients.
轻度认知障碍被认为是正常衰老与痴呆之间的过渡阶段。脑脊液中的磷酸化tau蛋白，以及顶叶、颞叶或扣带回区域更明显的脑葡萄糖代谢减退，对阿尔茨海默病的诊断具有良好的特异性，可能是早期确定阿尔茨海默病病理的有用辅助工具。
我们使用18F-氟-2-脱氧-D-葡萄糖正电子发射断层扫描技术，对16例轻度认知障碍患者和年龄匹配的对照受试者测量了脑脊液中苏氨酸181位点磷酸化的tau蛋白、脑脊液总tau蛋白以及脑葡萄糖代谢情况。
阿尔茨海默病典型的脑葡萄糖代谢模式与磷酸化tau水平升高显著相关（p = 0.009），但与总tau水平升高无关。在7例磷酸化tau浓度升高的轻度认知障碍患者中，有6例发现了阿尔茨海默病典型的正电子发射断层扫描模式。磷酸化tau测量能够区分有和没有阿尔茨海默病典型正电子发射断层扫描结果的患者，敏感性为85.7%特异度为88.9%。
与总tau水平不同，在轻度认知障碍患者中，磷酸化tau水平升高与阿尔茨海默病典型的脑葡萄糖代谢模式密切相关。这些结果可被解释为对磷酸化tau测量用于检测轻度认知障碍患者中阿尔茨海默病的验证。
