Mukaetova-Ladinska Elizabeta B, Monteith Rachael, Perry Elaine K
Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Westgate Road, Newcastle upon Tyne, Newcastle NE5 5PL, UK.
Int J Alzheimers Dis. 2010 Oct 17;2010:536538. doi: 10.4061/2010/536538.
More than 750,000 of the UK population suffer from some form of cognitive impairment and dementia. Of these, 5-20% will have Dementia with Lewy Bodies (DLB). Clinico-pathological studies have shown that it is the low frequency of DLB clinical core features that makes the DLB diagnosis hardly recognisable during life, and easily misdiagnosed for other forms of dementia. This has an impact on the treatment and long-term care of the affected subjects. Having a biochemical test, based on quantification of a specific DLB biomarker within Cerebrospinal Fluid (CSF) could be an effective diagnostic method to improve the differential diagnosis. Although some of the investigated DLB CSF biomarkers are well within the clinical criteria for sensitivity and specificity (>90%), they all seem to be confounded by the contradictory data for each of the major groups of biomarkers (α-synuclein, tau and amyloid proteins). However, a combination of CSF measures appear to emerge, that may well be able to differentiate DLB from other dementias: α-synuclein reduction in early DLB, a correlation between CSF α-synuclein and Aβ42 measures (characteristic for DLB only), and t-tau and p-tau181 profile (differentiating AD from DLB).
英国超过75万人患有某种形式的认知障碍和痴呆症。其中，5%-20%的人患有路易体痴呆（DLB）。临床病理研究表明，正是DLB临床核心特征的低发生率使得DLB在生前难以被诊断出来，并且很容易被误诊为其他形式的痴呆症。这对受影响患者的治疗和长期护理产生了影响。基于脑脊液（CSF）中特定DLB生物标志物定量的生化检测可能是一种有效的诊断方法，有助于改善鉴别诊断。尽管一些研究的DLB脑脊液生物标志物在敏感性和特异性方面（>90%）完全符合临床标准，但它们似乎都受到了各主要生物标志物组（α-突触核蛋白、tau蛋白和淀粉样蛋白）相互矛盾数据的干扰。然而，似乎出现了一种脑脊液检测指标的组合，很可能能够将DLB与其他痴呆症区分开来：早期DLB中α-突触核蛋白减少、脑脊液α-突触核蛋白与Aβ42检测指标之间的相关性（仅DLB具有特征性），以及t-tau和p-tau181图谱（区分AD与DLB）。
