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脑脊液对阿尔茨海默病和路易体痴呆的诊断

CSF diagnosis of Alzheimer's disease and dementia with Lewy bodies.

作者信息

Bibl M, Mollenhauer B, Esselmann H, Lewczuk P, Trenkwalder C, Brechlin P, Rüther E, Kornhuber J, Otto M, Wiltfang J

机构信息

Department of Psychiatry, University of Goettingen, Goettingen, Germany.

出版信息

J Neural Transm (Vienna). 2006 Nov;113(11):1771-8. doi: 10.1007/s00702-006-0537-z. Epub 2006 Aug 17.

Abstract

Differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) is often crucial. CSF Tau protein and Amyloid-beta (A beta) peptides have shown diagnostic value for the diagnosis of AD, but discrimination from DLB was poor.Herein, we investigate CSF of 18 patients with probable AD, 25 with probable DLB and 14 non-demented disease controls (NDC) by A beta-SDS-PAGE/immunoblot and commercially available ELISAs for A beta1-42 and tau. CSF A beta peptide patterns and tau exhibited disease specific alterations among AD and DLB. The ratio of A beta1-42 to A beta1-38 and A beta1-42 to A beta1-37, respectively, in combination with absolute tau, yielded a sensitivity and specificity of 100 and 92%, respectively. We conclude that CSF A beta peptide patterns and tau levels reflect disease-specific pathophysiological pathways of these dementias as distinct neurochemical phenotypes. Combined evaluation of these biomarkers provides a reasonable accuracy for differential diagnosis of AD and DLB.

摘要

阿尔茨海默病(AD)与路易体痴呆(DLB)的鉴别诊断往往至关重要。脑脊液 Tau 蛋白和淀粉样β肽(Aβ)对 AD 的诊断具有一定价值,但与 DLB 的鉴别效果不佳。在此,我们通过 Aβ-SDS-PAGE/免疫印迹法以及市售的 Aβ1-42 和 tau 酶联免疫吸附测定法(ELISA),对 18 例可能患有 AD 的患者、25 例可能患有 DLB 的患者以及 14 例非痴呆疾病对照(NDC)的脑脊液进行了研究。脑脊液 Aβ肽谱和 tau 在 AD 和 DLB 中呈现出疾病特异性改变。Aβ1-42 与 Aβ1-38 的比值以及 Aβ1-42 与 Aβ1-37 的比值,再结合 tau 的绝对值,其敏感性和特异性分别为 100%和 92%。我们得出结论,脑脊液 Aβ肽谱和 tau 水平反映了这些痴呆症作为不同神经化学表型的疾病特异性病理生理途径。对这些生物标志物进行联合评估,在 AD 和 DLB 的鉴别诊断中具有合理的准确性。

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