title: CSF α-synuclein does not discriminate dementia with Lewy bodies from Alzheimer's disease.
abstract: In this study, we assessed whether cerebrospinal fluid (CSF) levels of the biomarker α-synuclein have a diagnostic value in differential diagnosis of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). We also analyzed associations between CSF biomarkers and cognitive performance in DLB and in AD. We included 35 DLB patients, 63 AD patients, 18 patients with Parkinson's disease (PD), and 34 patients with subjective complaints (SC). Neuropsychological performance was measured by means of the Mini-Mental Status Examination (MMSE), Visual Association Test (VAT), VAT object-naming, Trail Making Test, and category fluency. In CSF, levels of α-synuclein, amyloid-β 1-42 (Aβ1-42), total tau (tau), and tau phosphorylated at threonine 181 (ptau-181) were measured. CSF α-synuclein levels did not differentiate between diagnostic groups (p=0.16). Higher ptau-181 and higher tau levels differentiated AD from DLB patients (p< 0.05). In DLB patients, lower Aβ1-42 and higher total tau levels were found than in SC and PD patients (p< 0.05). In DLB patients, linear regression analyses of CSF biomarkers showed that lower α-synuclein was related to lower MMSE-scores (β (SE) = 6(2) and p< 0.05) and fluency (β (SE) = 4(2), p< 0.05). Ultimately, CSF α-synuclein was not a useful diagnostic biomarker to differentiate DLB and/or PD (α-synucleinopathies) from AD or SC. In DLB patients maybe lower CSF α-synuclein levels are related to worse cognitive performance.
authors.affiliation: Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands. f.reesink@vumc.nl
authors.forename: Fransje E
authors.initials: FE
authors.lastname: Reesink
authors.forename: Afina W
authors.initials: AW
authors.lastname: Lemstra
authors.forename: Karin D
authors.initials: KD
authors.lastname: van Dijk
authors.forename: Henk W
authors.initials: HW
authors.lastname: Berendse
authors.forename: Wilma D J
authors.initials: WD
authors.lastname: van de Berg
authors.forename: Martin
authors.initials: M
authors.lastname: Klein
authors.forename: Marinus A
authors.initials: MA
authors.lastname: Blankenstein
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.forename: Marcel M
authors.initials: MM
authors.lastname: Verbeek
authors.forename: Wiesje M
authors.initials: WM
authors.lastname: van der Flier
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000523:psychology; D015415:Biomarkers / Q000134:cerebrospinal fluid; D010054:Brief Psychiatric Rating Scale; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D051844:alpha-Synuclein / Q000134:cerebrospinal fluid*
chemical_list: D015415:Biomarkers; D051844:alpha-Synuclein