Wolfsgruber Steffen, Polcher Alexandra, Koppara Alexander, Kleineidam Luca, Frölich Lutz, Peters Oliver, Hüll Michael, Rüther Eckart, Wiltfang Jens, Maier Wolfgang, Kornhuber Johannes, Lewczuk Piotr, Jessen Frank, Wagner Michael
Department of Psychiatry and Psychotherapy, University of Bonn, Germany.
German Center for Neurodegenerative Diseases, Bonn, Germany.
J Alzheimers Dis. 2017;58(3):939-950. doi: 10.3233/JAD-161252.
There is very limited data on the prevalence of abnormal cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD) and their predictive value for clinical progression in memory clinic patients with subjective cognitive decline (SCD).
To assess the frequency of abnormal CSF biomarkers of AD and their predictive value for clinical progression in memory clinic patients with SCD in comparison to patients with mild cognitive impairment (MCI) from the same cohort.
We analyzed prospective data from memory clinic patients of the German Competence Network Dementia cohort with a baseline diagnosis of SCD (n = 82) or MCI (n = 134), distinguished by actuarial neuropsychological MCI criteria ("Jak-Bondi criteria"). Risk of clinical progression during 3-year follow-up was evaluated with Cox-Proportional-Hazard models.
Prevalence of abnormal values in CSF markers of tau-mediated neurodegeneration (67.8% versus 46.3%) but not of amyloid deposition (40.3% versus 35.4%) was significantly higher in MCI compared to SCD. The rate of incident AD dementia (26.1% versus 12.2%) was also significantly higher in MCI. In SCD, additional 22% progressed to MCI during follow-up. Combined amyloid/tau abnormality was the strongest predictor of clinical progression in both groups.
High prevalence of biomarker abnormality and clinical progression, together with the predictive value of CSF biomarkers, in memory clinic patients with SCD support the validity and usefulness of this condition as a "pre-MCI" at risk stage of AD.
关于阿尔茨海默病（AD）异常脑脊液（CSF）生物标志物的患病率及其对记忆门诊主观认知下降（SCD）患者临床进展的预测价值的数据非常有限。
与来自同一队列的轻度认知障碍（MCI）患者相比，评估AD异常CSF生物标志物的频率及其对记忆门诊SCD患者临床进展的预测价值。
我们分析了德国痴呆症能力网络队列中记忆门诊患者的前瞻性数据，这些患者基线诊断为SCD（n = 82）或MCI（n = 134），根据精算神经心理学MCI标准（“Jak-Bondi标准”）进行区分。使用Cox比例风险模型评估3年随访期间临床进展的风险。
与SCD相比，MCI中tau介导的神经退行性变CSF标志物异常值的患病率（67.8%对46.3%）显著更高，但淀粉样蛋白沉积异常值的患病率（40.3%对35.4%）并非如此。MCI中AD痴呆的发病率（26.1%对12.2%）也显著更高。在SCD中，随访期间另有22%进展为MCI。淀粉样蛋白/ tau联合异常是两组临床进展的最强预测因子。
SCD记忆门诊患者生物标志物异常和临床进展的高患病率，以及CSF生物标志物的预测价值，支持了这种情况作为AD风险阶段“MCI前期”的有效性和实用性。
