de Leon M J, Mosconi L, Li J, De Santi S, Yao Y, Tsui W H, Pirraglia E, Rich K, Javier E, Brys M, Glodzik L, Switalski R, Saint Louis L A, Pratico D
New York University, School of Medicine, Center for Brain Health MHL 400, New York, NY 10016, USA.
J Neurol. 2007 Dec;254(12):1666-75. doi: 10.1007/s00415-007-0610-z. Epub 2007 Nov 14.
Very little data exist to evaluate the value of longitudinal CSF biological markers for Alzheimer's disease (AD). Most studies indicate that tau and amyloid beta markers do not reflect disease progression. We now report on a longitudinal, three-time point, CSF Isoprostane (IsoP) and quantitative MRI study that examined 11 normal elderly (NL) volunteers and 6 Mild Cognitive Impairment (MCI) patients. After 4 years, all 6 MCI patients declined to AD and 2 of the NL subjects declined to MCI. At baseline and longitudinally, the MCI patients showed reduced delayed memory, increased IsoP levels, and reduced medial temporal lobe gray matter concentrations as compared to NL. A group comprised of all decliners to AD or to MCI (n = 8) was distinguished at baseline from the stable NL controls (n = 9) by IsoP with 100% accuracy.Moreover, both at baseline and longitudinally, the IsoP measures significantly improved the diagnostic and predictive outcomes of conventional memory testing and quantitative MRI measurements. These data indicate that IsoP is potentially useful for both the early detection of AD-related pathology and for monitoring the course of AD.
用于评估阿尔茨海默病（AD）纵向脑脊液生物标志物价值的数据非常少。大多数研究表明，tau蛋白和淀粉样β蛋白标志物不能反映疾病进展。我们现在报告一项纵向、三个时间点的脑脊液异前列腺素（IsoP）和定量MRI研究，该研究检查了11名正常老年人（NL）志愿者和6名轻度认知障碍（MCI）患者。4年后，所有6名MCI患者均发展为AD，2名NL受试者发展为MCI。在基线和纵向研究中，与NL相比，MCI患者表现出延迟记忆减退、IsoP水平升高以及内侧颞叶灰质浓度降低。由所有发展为AD或MCI的受试者（n = 8）组成的一组在基线时通过IsoP与稳定的NL对照组（n = 9）区分开来，准确率为100%。此外，在基线和纵向研究中，IsoP测量均显著改善了传统记忆测试和定量MRI测量的诊断和预测结果。这些数据表明，IsoP对于AD相关病理的早期检测和AD病程的监测都可能有用。
