Alexopoulos Panagiotis, Werle Lukas, Roesler Jennifer, Thierjung Nathalie, Gleixner Lena Sophie, Yakushev Igor, Laskaris Nikolaos, Wagenpfeil Stefan, Gourzis Philippos, Kurz Alexander, Perneczky Robert
Department of Psychiatry, University Hospital of Rion, University of Patras, 26504, Rio, Patras, Greece.
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany.
Alzheimers Res Ther. 2016 Dec 9;8(1):51. doi: 10.1186/s13195-016-0220-z.
According to new diagnostic guidelines for Alzheimer's disease (AD), biomarkers enable estimation of the individual likelihood of underlying AD pathophysiology and the associated risk of progression to AD dementia for patients with mild cognitive impairment (MCI). Nonetheless, how conflicting biomarker constellations affect the progression risk is still elusive. The present study explored the impact of different cerebrospinal fluid (CSF) biomarker constellations on the progression risk of MCI patients.
A multicentre cohort of 469 patients with MCI and available CSF biomarker results and clinical follow-up data was considered. Biomarker values were categorized as positive for AD, negative or borderline. Progression risk differences between patients with different constellations of total Tau (t-Tau), phosphorylated Tau at threonine 181 (p-Tau) and amyloid-beta 1-42 (Aβ) were studied. Group comparison analyses and Cox regression models were employed.
Patients with all biomarkers positive for AD (N = 145) had the highest hazard for progression to dementia due to AD, whilst patients with no positive biomarkers (N = 111) had the lowest. The risk of patients with only abnormal p-Tau and/or t-Tau (N = 49) or with positive Aβ in combination with positive t-Tau or p-Tau (N = 119) is significantly lower than that of patients with all biomarkers positive.
The risk of progression to dementia due to AD differs between patients with different CSF biomarker constellations.
根据阿尔茨海默病（AD）的新诊断指南，生物标志物能够估计轻度认知障碍（MCI）患者潜在AD病理生理学的个体可能性以及进展为AD痴呆的相关风险。尽管如此，相互矛盾的生物标志物组合如何影响进展风险仍不清楚。本研究探讨了不同脑脊液（CSF）生物标志物组合对MCI患者进展风险的影响。
纳入了一个多中心队列，共469例MCI患者，这些患者有可用的CSF生物标志物结果和临床随访数据。生物标志物值被分类为AD阳性、阴性或临界值。研究了总tau蛋白（t-Tau）、苏氨酸181位点磷酸化tau蛋白（p-Tau）和淀粉样β蛋白1-42（Aβ）不同组合的患者之间的进展风险差异。采用组间比较分析和Cox回归模型。
所有生物标志物均为AD阳性的患者（N = 145）进展为AD痴呆的风险最高，而无阳性生物标志物的患者（N = 111）风险最低。仅p-Tau和/或t-Tau异常的患者（N = 49）或Aβ阳性合并t-Tau或p-Tau阳性的患者（N = 119）的风险显著低于所有生物标志物均为阳性的患者。
不同CSF生物标志物组合的患者进展为AD痴呆的风险不同。
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