Bouwman F H, van der Flier W M, Schoonenboom N S M, van Elk E J, Kok A, Rijmen F, Blankenstein M A, Scheltens P
Alzheimer Center and Department of Neurology, VU Medical Center, Amsterdam, The Netherlands.
Neurology. 2007 Sep 4;69(10):1006-11. doi: 10.1212/01.wnl.0000271375.37131.04.
In Alzheimer disease (AD), longitudinal changes of beta-amyloid(1-42) (Abeta(1-42)), tau, and phosphorylated tau at threonine 181 (ptau-181) in CSF have been reported in small studies only. We evaluated the natural course of CSF biomarkers in patients with AD, subjective complaints, and mild cognitive impairment (MCI).
One hundred five patients (50 AD, 38 MCI, 17 subjective complaints) underwent two lumbar punctures, with a mean interval of 21 +/- 9 months. CSF levels of Abeta(1-42), tau, and ptau-181 were measured.
CSF Abeta(1-42) and tau levels showed main effects for both diagnosis and time (all p < 0.05), with average increases of 47 +/- 72 and 49 +/- 143 pg/mL. The interaction terms were not significant, which implies a similar time effect for all diagnostic groups. CSF ptau-181 levels showed a main effect for diagnosis (p = 0.01) but not for time (p = 0.27, increase of 1.0 +/- 12 pg/mL).
Levels of CSF beta-amyloid(1-42) and tau but not phosphorylated tau at threonine 181 increased over time in this memory clinic patient cohort with comparable change in all diagnostic groups. The cross-sectional difference between diagnostic groups, however, exceeded by far the longitudinal changes within individuals, suggesting that these biomarkers are not sensitive as markers of disease progression.
在阿尔茨海默病(AD)中,仅有小规模研究报道了脑脊液中β-淀粉样蛋白(1-42)(Aβ(1-42))、tau蛋白以及苏氨酸181位点的磷酸化tau蛋白(p-tau-181)的纵向变化。我们评估了AD、主观认知主诉和轻度认知障碍(MCI)患者脑脊液生物标志物的自然病程。
105例患者(50例AD、38例MCI、17例主观认知主诉)接受了两次腰椎穿刺,平均间隔时间为21±9个月。检测脑脊液中Aβ(1-42)、tau蛋白和p-tau-181的水平。
脑脊液Aβ(1-42)和tau蛋白水平在诊断和时间上均显示出主效应(所有p<0.05),平均增加量分别为47±72和49±143 pg/mL。交互项不显著,这意味着所有诊断组的时间效应相似。脑脊液p-tau-181水平在诊断上显示出主效应(p = 0.01),但在时间上无主效应(p = 0.27,增加量为1.0±12 pg/mL)。
在这个记忆门诊患者队列中,脑脊液β-淀粉样蛋白(1-42)和tau蛋白水平随时间增加,而苏氨酸181位点的磷酸化tau蛋白水平未增加,所有诊断组的变化具有可比性。然而,诊断组之间的横断面差异远远超过个体内部的纵向变化,这表明这些生物标志物作为疾病进展的标志物并不敏感。