title: Cerebrospinal fluid tau and beta-amyloid in Alzheimer patients, disease controls and an age-matched random sample.
abstract: We prospectively evaluated the diagnostic accuracy of cerebrospinal fluid (CSF)-beta-amyloid1-42 (Abeta42), -total-tau (tau) and -phosphorylated-tau181 (p-tau181) as measured by sandwich ELISAs in the clinical routine of a community state hospital to discriminate between patients with Alzheimer's disease (AD), healthy controls (HC), non-AD-dementias, a group composed of various psychiatric disorders (non-AD-dementias, mental diseases) and an age-matched random sample (RS) (total N=219). By comparing patients with AD to HC as reference, tau revealed sensitivity (sens)/specificity (spec) of 88%/80%, p-tau(181) 88%/80%, tau/Abeta42-ratio 81%/85% and phospho-tau(181)/Abeta42-ratio 81%/78%. Discriminative power between HC and all dementias under investigation was estimated lower for tau (78%/77%) and p-tau(181) (73%/79%). Relative to patients with AD, ROC analysis for the RS revealed highest sens/spec for p-tau181 (79%/77%) and p-tau181/Abeta42 ratio (78%/75%). Differentiation between AD versus a group made of patients with various psychiatric disorders was optimised by using CSF-p-tau181 (80%/77%). Under clinical routine conditions current CSF-biomarkers show a substantial capacity to discriminate between AD and HC as reference and to mark off AD patients from RS and heterogeneous diagnostic groups composed of non-AD dementias and other psychiatric conditions. Despite a residual substantial overlap between the groups, we conclude that current CSF markers are well suited to support AD-related diagnostic procedures in every-day clinics.
authors.affiliation: Department of Psychiatry, Psychosomatics and Psychotherapy, Geriatric Psychiatry Research Group, University of Regensburg at the Bezirksklinikum, Universitätsstrasse 84, D-93053 Regensburg, Germany. bernd.ibach@klinik.uni-regensburg.de
authors.forename: Bernd
authors.initials: B
authors.lastname: Ibach
authors.forename: Harald
authors.initials: H
authors.lastname: Binder
authors.forename: Margarethe
authors.initials: M
authors.lastname: Dragon
authors.forename: Stefan
authors.initials: S
authors.lastname: Poljansky
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Haen
authors.forename: Eberhard
authors.initials: E
authors.lastname: Schmitz
authors.forename: Horst
authors.initials: H
authors.lastname: Koch
authors.forename: Albert
authors.initials: A
authors.lastname: Putzhammer
authors.forename: Hans
authors.initials: H
authors.lastname: Kluenemann
authors.forename: Wolf
authors.initials: W
authors.lastname: Wieland
authors.forename: Goeran
authors.initials: G
authors.lastname: Hajak
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid*; D019540:Area Under Curve; D015415:Biomarkers / Q000134:cerebrospinal fluid; D016022:Case-Control Studies; D003704:Dementia / Q000134:cerebrospinal fluid; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000134:cerebrospinal fluid*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42); D016875:tau Proteins