CSF biomarkers and medial temporal lobe atrophy predict dementia in mild cognitive impairment.
OBJECTIVE
To study CSF biomarkers, beta-amyloid(1-42) (Abeta(1-42)) and tau, and medial temporal lobe atrophy (MTA) on MRI in their ability to predict dementia in patients with mild cognitive impairment (MCI).


METHODS
Fifty-nine MCI patients (49% male, mean age 69+/-8), follow-up 19 months, were included. Baseline CSF levels of Abeta(1-42), tau and MTA-score were dichotomized.


RESULTS
Thirty-three (56%) of the MCI patients progressed to dementia, 30 of which had Alzheimer's disease. Lower CSF Abeta(1-42) level, higher CSF-tau and higher MTA-scores at baseline were found in progressed patients. Cox proportional hazards models revealed that abnormal CSF Abeta(1-42), CSF tau and MTA were significantly associated with dementia at follow-up (hazard ratio (95% confidence interval): 4.0 (1.3-12.1), 5.9 (1.6-21.7) and 2.1 (1.0-4.6)). A fourfold higher risk was found for patients with both abnormal CSF biomarkers and MTA compared to patients with either test abnormal. Ninety-four percent of patients with both abnormalities converted to dementia.


CONCLUSIONS
These findings suggest an added value of CSF to MRI in the diagnostic work up of patients presenting at a memory clinic.
Bouwman
F H
FH
Department of Neurology, Alzheimer Centre, VU Medical Center, MB Amsterdam, The Netherlands. femke.bouwman@vumc.nl <femke.bouwman@vumc.nl>
Schoonenboom
S N M
SN
van der Flier
W M
WM
van Elk
E J
EJ
Kok
A
A
Barkhof
F
F
Blankenstein
M A
MA
Scheltens
Ph
P
D000368:Aged; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid*; D001284:Atrophy; D003072:Cognition Disorders / Q000134:cerebrospinal fluid* / Q000473:pathology*; D003704:Dementia / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000134:cerebrospinal fluid*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013702:Temporal Lobe / Q000473:pathology*; D016875:tau Proteins / Q000134:cerebrospinal fluid
D016229:Amyloid beta-Peptides; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42); D016875:tau Proteins