Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
J Alzheimers Dis. 2020;74(2):473-490. doi: 10.3233/JAD-191109.
The diagnostic performances of cerebrospinal fluid (CSF) biomarkers and amyloid positron emission tomography (PET) were compared by examining the association and concordance or discordance between CSF Aβ1-42 and amyloid PET, after determining our own cut-off values for CSF Alzheimer's disease (AD) biomarkers. Furthermore, we evaluated the ability of CSF biomarkers and amyloid PET to predict clinical progression. CSF Aβ1-42, t-tau, and p-tau levels were analyzed in 203 individuals [27 normal controls, 38 mild cognitive impairment (MCI), 62 AD dementia, and 76 patients with other neurodegenerative diseases] consecutively recruited from two dementia clinics. We used both visual and standardized uptake value ratio (SUVR)-based amyloid PET assessments for analyses. The association of CSF biomarkers with amyloid PET SUVR, hippocampal atrophy, and cognitive function were investigated by linear regression analysis, and the risk of conversion from MCI to AD dementia was assessed using a Cox proportional hazards model. CSF p-tau/Aβ1-42 and t-tau/Aβ1-42 exhibited the best diagnostic accuracies among the CSF AD biomarkers examined. Correlations were observed between CSF biomarkers and global SUVR, hippocampal volume, and cognitive function. Overall concordance and discordance between CSF Aβ1-42 and amyloid PET was 77% and 23%, respectively. Baseline positive CSF Aβ1-42 for MCI demonstrated a 5.6-fold greater conversion risk than negative CSF Aβ1-42 . However, amyloid PET findings failed to exhibit significant prognostic value. Therefore, despite presence of a significant correlation between the CSF Aβ1-42 level and SUVR of amyloid PET, and a relevant concordance between CSF Aβ1-42 and amyloid PET, baseline CSF Aβ1-42 better predicted AD conversion.
我们通过考察脑脊液（CSF）中的 Aβ1-42 与淀粉样 PET 之间的相关性、一致性或不一致性，来比较 CSF 生物标志物和淀粉样 PET 的诊断性能，在确定我们自己的 CSF 阿尔茨海默病（AD）生物标志物的临界值后进行了这项检查。此外，我们评估了 CSF 生物标志物和淀粉样 PET 预测临床进展的能力。我们对 203 名个体（27 名正常对照、38 名轻度认知障碍（MCI）、62 名 AD 痴呆和 76 名其他神经退行性疾病患者）的 CSF Aβ1-42、t- tau 和 p- tau 水平进行了分析，这些个体是从两个痴呆症诊所连续招募的。我们使用视觉和标准化摄取值比（SUVR）评估的淀粉样 PET 分析来进行分析。通过线性回归分析研究了 CSF 生物标志物与淀粉样 PET SUVR、海马萎缩和认知功能之间的关联，并使用 Cox 比例风险模型评估了从 MCI 向 AD 痴呆转化的风险。在研究的 CSF AD 生物标志物中，CSF p-tau/Aβ1-42 和 t-tau/Aβ1-42 表现出最佳的诊断准确性。CSF 生物标志物与全球 SUVR、海马体积和认知功能之间存在相关性。CSF Aβ1-42 与淀粉样 PET 的总体一致性和不一致性分别为 77%和 23%。MCI 患者 CSF Aβ1-42 阳性的基线表现出比 CSF Aβ1-42 阴性高 5.6 倍的转换风险。然而，淀粉样 PET 结果未能显示出显著的预后价值。因此，尽管 CSF Aβ1-42 水平与淀粉样 PET 的 SUVR 之间存在显著相关性，以及 CSF Aβ1-42 与淀粉样 PET 之间存在相关性，但基线 CSF Aβ1-42 能更好地预测 AD 的转化。
