添加 MHPG 可改善路易体痴呆与阿尔茨海默病的生物标志物的区分，但不能改善其他类型痴呆的区分。
Addition of MHPG to Alzheimer's disease biomarkers improves differentiation of dementia with Lewy bodies from Alzheimer's disease but not other dementias.
机构信息
Department of Neurology, Radboud University Medical Centre, and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud Alzheimer Centre, Nijmegen, The Netherlands; Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.
Department of Neurology, Radboud University Medical Centre, and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
出版信息
Alzheimers Dement. 2014 Jul;10(4):448-455.e2. doi: 10.1016/j.jalz.2013.05.1775. Epub 2013 Nov 13.
BACKGROUND
Overlapping clinical features make it difficult to distinguish dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) and other dementia types. In this study we aimed to determine whether the combination of cerebrospinal fluid (CSF) biomarkers, amyloid-β42 (Aβ42), total tau protein (t-tau), and phosphorylated tau protein (p-tau), in combination with 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG), could be useful in discriminating DLB from vascular dementia (VaD) and frontotemporal dementia (FTD), as we previously demonstrated for differentiation of DLB from AD.
METHODS
We retrospectively analyzed concentrations of MHPG, Aβ42, t-tau, and p-tau in CSF in patients with DLB, AD, VaD, and FTD. Using previously developed multivariate logistic regression models we assessed the diagnostic value of these CSF parameters.
RESULTS
The currently used combination of Aβ42, t-tau, and p-tau yielded a sensitivity of 61.9% and a specificity of 91.7% for the discrimination between DLB and AD, but could not discriminate between DLB and VaD or FTD. The addition of MHPG to Aβ42, t-tau, and p-tau improves the discrimination of DLB from AD, yielding a sensitivity of 65.1% and specificity of 100%, but could not distinguish DLB from other forms of dementia.
CONCLUSIONS
Our results confirm in a separate patient cohort that addition of MHPG to Aβ42, t-tau, and p-tau improves the discrimination of DLB from AD but not the differentiation of DLB from VaD or FTD.
背景
重叠的临床特征使得难以将路易体痴呆（DLB）与阿尔茨海默病（AD）和其他痴呆类型区分开来。在这项研究中，我们旨在确定脑脊液（CSF）生物标志物——β-淀粉样蛋白 42（Aβ42）、总tau 蛋白（t-tau）和磷酸化tau 蛋白（p-tau）与 3-甲氧基-4-羟基苯乙二醇（MHPG）的组合是否有助于将 DLB 与血管性痴呆（VaD）和额颞叶痴呆（FTD）区分开来，正如我们之前为区分 DLB 与 AD 所证明的那样。
方法
我们回顾性分析了 DLB、AD、VaD 和 FTD 患者 CSF 中 MHPG、Aβ42、t-tau 和 p-tau 的浓度。使用先前开发的多变量逻辑回归模型，我们评估了这些 CSF 参数的诊断价值。
结果
目前使用的 Aβ42、t-tau 和 p-tau 的组合对 DLB 和 AD 之间的区分具有 61.9%的敏感性和 91.7%的特异性，但不能区分 DLB 和 VaD 或 FTD。将 MHPG 添加到 Aβ42、t-tau 和 p-tau 中可提高 DLB 与 AD 之间的区分度，敏感性为 65.1%，特异性为 100%，但无法区分 DLB 与其他类型的痴呆。
结论
我们的结果在另一个患者队列中证实，将 MHPG 添加到 Aβ42、t-tau 和 p-tau 中可提高 DLB 与 AD 的区分度，但不能区分 DLB 与 VaD 或 FTD。
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