Cerebrospinal fluid tau protein levels and 18F-fluorodeoxyglucose positron emission tomography in the differential diagnosis of Alzheimer's disease.
OBJECTIVE
In this study, we aimed to compare cerebrospinal fluid (CSF) levels of total tau (t-tau), phosphorylated tau (p-tau(181)) and positron emission tomography with (18)F-fluorodeoxyglucose (FDG-PET) in the differential diagnosis of Alzheimer's disease (AD) under clinical conditions.


METHODS
In a cross-sectional, blinded, single-center study, we examined a sample of 75 unselected memory clinic patients with clinical diagnoses of dementia of Alzheimer type (DAT; n = 24), amnestic mild cognitive impairment (MCI; n = 16), other dementias (n = 13) and nondemented controls (n = 22). Discriminative accuracy, sensitivity and specificity were calculated and compared using ROC analyses.


RESULTS
p-tau(181) and FDG-PET were comparable in separating DAT from controls (sensitivity: 67 vs. 79%; specificity: 91% for both) and patients with other dementias (sensitivity: 71 vs. 79%; specificity: 100% for both). The sensitivity of p-tau(181) in differentiating MCI patients from controls was significantly (p < 0.05) superior to that of FDG-PET (75 vs. 44%) at a comparably high specificity (82 vs. 91%); t-tau measures were less accurate in all analyses.


CONCLUSIONS
FDG-PET and CSF p-tau(181) levels are able to discriminate DAT in heterogeneous and unselected samples with a high accuracy. CSF p-tau(181) might be somewhat superior for a sensitive detection of patients with MCI.
Yakushev
Igor
I
Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany. igor.yakushev@uni-mainz.de
Bartenstein
Peter
P
Siessmeier
Thomas
T
Hiemke
Christoph
C
Scheurich
Armin
A
Lotz
Johannes
J
Fellgiebel
Andreas
A
Müller
Matthias J
MJ
D000368:Aged; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000000981:diagnostic imaging; D019540:Area Under Curve; D003072:Cognition Disorders / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008569:Memory Disorders / Q000523:psychology; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D012372:ROC Curve; D019275:Radiopharmaceuticals; D016875:tau Proteins / Q000134:cerebrospinal fluid*
D019275:Radiopharmaceuticals; D016875:tau Proteins; D019788:Fluorodeoxyglucose F18