Mollenhauer Brit, Trenkwalder Claudia, von Ahsen Nicolas, Bibl Mirko, Steinacker Petra, Brechlin Peter, Schindehuette Jan, Poser Sigrid, Wiltfang Jens, Otto Markus
Department of Neurology,Georg-August University, Kassel, Germany.
Dement Geriatr Cogn Disord. 2006;22(3):200-8. doi: 10.1159/000094871. Epub 2006 Aug 7.
Measurement of tau-protein and beta-amyloid(1-42 )(Abeta42) in cerebrospinal fluid (CSF) has gained increasing acceptance in the differential diagnosis of Alzheimer's disease. We investigated CSF tau-protein and Abeta42 concentrations in 73 patients with advanced idiopathic Parkinson's disease with dementia (PDD) and 23 patients with idiopathic Parkinson's disease without dementia (PD) and in a comparison group of 41 non-demented neurological patients (CG) using commercially available enzyme-linked-immunoabsorbant-assay (ELISA). tau-Protein levels were statistically significantly higher and Abeta42 lower in the PDD patients compared to PD patients and the CG. This observation was most marked (p < 0.05) in a subgroup of patients with PDD carrying the apolipoprotein genotype epsilon3/epsilon3. The distribution of the apolipoprotein genotypes in PDD and PD patients was similar to that of the CG. Although a significant difference in tau-protein values was observed between PDD and CG, no diagnostic cut-off value was established. These findings suggest that such protein CSF changes may help to support the clinical diagnosis of cognitive decline in PD and that there may be apolipoprotein-E-isoform-specific differences in CSF protein regulation in advanced PDD.
脑脊液(CSF)中tau蛋白和β-淀粉样蛋白(1-42)(Aβ42)的检测在阿尔茨海默病的鉴别诊断中越来越受到认可。我们使用市售的酶联免疫吸附测定(ELISA),对73例晚期特发性帕金森病伴痴呆(PDD)患者、23例无痴呆的特发性帕金森病(PD)患者以及41例非痴呆神经科患者组成的对照组(CG)的脑脊液tau蛋白和Aβ42浓度进行了研究。与PD患者和CG相比,PDD患者的tau蛋白水平在统计学上显著更高,而Aβ42水平更低。这一观察结果在携带载脂蛋白ε3/ε3基因型的PDD患者亚组中最为明显(p < 0.05)。PDD和PD患者中载脂蛋白基因型的分布与CG相似。尽管在PDD和CG之间观察到tau蛋白值存在显著差异,但未确定诊断临界值。这些发现表明,脑脊液中此类蛋白质变化可能有助于支持PD患者认知功能下降的临床诊断,并且在晚期PDD中脑脊液蛋白质调节可能存在载脂蛋白E异构体特异性差异。