Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands.
J Alzheimers Dis. 2010;22(1):87-95. doi: 10.3233/JAD-2010-100186.
In this study, we assessed whether cerebrospinal fluid (CSF) levels of the biomarker α-synuclein have a diagnostic value in differential diagnosis of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). We also analyzed associations between CSF biomarkers and cognitive performance in DLB and in AD. We included 35 DLB patients, 63 AD patients, 18 patients with Parkinson's disease (PD), and 34 patients with subjective complaints (SC). Neuropsychological performance was measured by means of the Mini-Mental Status Examination (MMSE), Visual Association Test (VAT), VAT object-naming, Trail Making Test, and category fluency. In CSF, levels of α-synuclein, amyloid-β 1-42 (Aβ1-42), total tau (tau), and tau phosphorylated at threonine 181 (ptau-181) were measured. CSF α-synuclein levels did not differentiate between diagnostic groups (p=0.16). Higher ptau-181 and higher tau levels differentiated AD from DLB patients (p< 0.05). In DLB patients, lower Aβ1-42 and higher total tau levels were found than in SC and PD patients (p< 0.05). In DLB patients, linear regression analyses of CSF biomarkers showed that lower α-synuclein was related to lower MMSE-scores (β (SE) = 6(2) and p< 0.05) and fluency (β (SE) = 4(2), p< 0.05). Ultimately, CSF α-synuclein was not a useful diagnostic biomarker to differentiate DLB and/or PD (α-synucleinopathies) from AD or SC. In DLB patients maybe lower CSF α-synuclein levels are related to worse cognitive performance.
在这项研究中，我们评估了脑脊液（CSF）中生物标志物α-突触核蛋白水平在鉴别诊断路易体痴呆（DLB）和阿尔茨海默病（AD）中的诊断价值。我们还分析了 CSF 生物标志物与 DLB 和 AD 患者认知表现之间的相关性。我们纳入了 35 名 DLB 患者、63 名 AD 患者、18 名帕金森病（PD）患者和 34 名有主观抱怨（SC）的患者。神经心理学表现通过简易精神状态检查（MMSE）、视觉联想测试（VAT）、VAT 物体命名、连线测试和类别流畅性来测量。在 CSF 中，测量了α-突触核蛋白、淀粉样蛋白-β1-42（Aβ1-42）、总 tau（tau）和 tau 磷酸化 threonine 181（ptau-181）的水平。CSF α-突触核蛋白水平不能区分诊断组（p=0.16）。较高的 ptau-181 和较高的 tau 水平区分了 AD 与 DLB 患者（p<0.05）。在 DLB 患者中，与 SC 和 PD 患者相比，Aβ1-42 水平较低，总 tau 水平较高（p<0.05）。在 DLB 患者中，CSF 生物标志物的线性回归分析表明，较低的 α-突触核蛋白与较低的 MMSE 评分（β（SE）=6（2）和 p<0.05）和流畅性（β（SE）=4（2），p<0.05）有关。最终，CSF α-突触核蛋白不是区分 DLB 和/或 PD（α-突触核蛋白病）与 AD 或 SC 的有用诊断生物标志物。在 DLB 患者中，CSF α-突触核蛋白水平较低可能与认知表现较差有关。
