可能的脑淀粉样血管病的 Tau、磷酸化 Tau、Aβ42 和 Aβ40 的脑脊液特征。
Cerebrospinal Fluid Profile of Tau, Phosphorylated Tau, Aβ42, and Aβ40 in Probable Cerebral Amyloid Angiopathy.
机构信息
Normandie Univ, UNIROUEN, Inserm U1245 and CHURouen, Department of Neurology and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France.
CMRR Paris Nord AP-HP, Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, INSERM, U942, Université Paris Diderot, Sorbonne Paris Cité, UMRS 942, France.
出版信息
J Alzheimers Dis. 2022;87(2):791-802. doi: 10.3233/JAD-215208.
BACKGROUND
There is no consensus regarding the diagnostic value of cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers in cerebral amyloid angiopathy (CAA).
OBJECTIVE
To describe the CSF levels of Aβ42, Aβ40, total protein Tau, and phosphorylated-Tau (p-Tau) in a large series of probable CAA patients and to compare with AD patients in order to identify a specific pattern in CAA but also to look for correlations with the neuroimaging profile.
METHODS
We retrospectively included from 2 French centers probable CAA patients according to modified Boston criteria who underwent lumbar puncture (LP) with CSF AD biomarker quantifications. Two neurologists independently analyzed all MRI sequences. A logistic regression and Spearman's correlation coefficient were used to identify correlation between MRI and CSF biomarkers in CAA.
RESULTS
We included 63 probable CAA and 27 AD patients. Among CAA 50.8% presented with decreased Aβ42 level associated with elevated p-Tau and/or Tau, 34.9% with isolated decreased Aβ42 level and 14.3% patients with normal Aβ42 level. Compared to AD, CAA showed lower levels of Tau (p = 0.008), p-Tau (p = 0.004), and Aβ40 (p = 0.001) but similar Aβ42 level (p = 0.07). No correlation between Aβ42 or Aβ40 levels and neuroimaging was found.
CONCLUSION
CSF biomarkers may improve the accuracy of the modified Boston criteria with altered profile in 85% of the patients fulfilling revised Boston criteria for probable CAA. Aβ40 appears as an interesting selective biomarker in differential diagnosis.
背景
在脑淀粉样血管病（CAA）中，脑脊液（CSF）阿尔茨海默病（AD）生物标志物的诊断价值尚无共识。
目的
描述大量可能的 CAA 患者的 CSF 中 Aβ42、Aβ40、总蛋白 Tau 和磷酸化-Tau（p-Tau）水平，并与 AD 患者进行比较，以确定 CAA 的特定模式，同时寻找与神经影像学特征的相关性。
方法
我们回顾性地纳入了来自法国 2 个中心的根据改良波士顿标准诊断的可能的 CAA 患者，这些患者接受了腰椎穿刺（LP）和 CSF AD 生物标志物定量检测。两名神经科医生独立分析了所有 MRI 序列。使用逻辑回归和斯皮尔曼相关系数来识别 CAA 中 MRI 和 CSF 生物标志物之间的相关性。
结果
我们纳入了 63 例可能的 CAA 和 27 例 AD 患者。在 CAA 中，50.8%患者的 Aβ42 水平降低，同时伴有升高的 p-Tau 和/或 Tau，34.9%患者的 Aβ42 水平单纯降低，14.3%患者的 Aβ42 水平正常。与 AD 相比，CAA 患者的 Tau（p=0.008）、p-Tau（p=0.004）和 Aβ40（p=0.001）水平较低，但 Aβ42 水平相似（p=0.07）。未发现 Aβ42 或 Aβ40 水平与神经影像学之间存在相关性。
结论
CSF 生物标志物可能会提高改良波士顿标准的准确性，对于符合修订后的波士顿 CAA 标准的患者，85%的患者的 CSF 生物标志物会有改变的特征。Aβ40 似乎是鉴别诊断中的一个有前途的选择性生物标志物。
Zotero 插件