title: Accuracy of a panel of 5 cerebrospinal fluid biomarkers in the differential diagnosis of patients with dementia and/or parkinsonian disorders.
abstract: OBJECTIVE
  To assess the ability of 5 cerebrospinal fluid(CSF) biomarkers to differentiate between common dementia and parkinsonian disorders.
  
  
  METHODS
  A cross-sectional, clinic-based study.
  
  
  METHODS
  Cerebrospinal fluid samples (N=453) were obtained from healthy individuals serving as controls and from patients with Parkinson disease (PD), PD with dementia(PDD), dementia with Lewy bodies (DLB), Alzheimer disease (AD), progressive supranuclear palsy(PSP), multiple system atrophy (MSA), or corticobasal degeneration (CBD).
  
  
  METHODS
  Neurology and memory disorder clinics.
  
  
  METHODS
  Cerebrospinal fluid biomarker levels in relation to clinical diagnosis.
  
  
  RESULTS
  Cerebrospinal fluid levels of -synuclein were decreased in patients with PD, PDD, DLB, and MSA but increased in patients with AD. Cerebrospinal fluid levels of α-amyloid 1-42 were decreased in DLB and even further decreased in AD. Cerebrospinal fluid levels of total tau and hyperphosphorylated tau were increased in AD. Multivariate analysis revealed that these biomarkers could differentiate AD from DLB and PDD with an area under the curve of 0.90, with -synuclein and total tau contributing most to the model. Cerebrospinal fluid levels of neurofilament light chain were substantially increased in atypical parkinsonian disorders (ie, PSP, MSA,and CBD), and multivariate analysis revealed that the level of neurofilament light chain alone could differentiate PD from atypical parkinsonian disorders, with an area under the curve of 0.93.
  
  
  CONCLUSIONS
  Ascertainment of the -synuclein level in CSF somewhat improves the differential diagnosis of AD vs DLB and PDD when combined with established AD biomarkers.The level of neurofilament light chain alone may differentiate PD from atypical parkinsonian disorders.
authors.affiliation: Department of Clinical Sciences, Lund University.
authors.forename: Sara
authors.initials: S
authors.lastname: Hall
authors.forename: Annika
authors.initials: A
authors.lastname: Öhrfelt
authors.forename: Radu
authors.initials: R
authors.lastname: Constantinescu
authors.forename: Ulf
authors.initials: U
authors.lastname: Andreasson
authors.forename: Yulia
authors.initials: Y
authors.lastname: Surova
authors.forename: Frederick
authors.initials: F
authors.lastname: Bostrom
authors.forename: Christer
authors.initials: C
authors.lastname: Nilsson
authors.forename: Widner
authors.initials: W
authors.lastname: Håkan
authors.forename: Hilde
authors.initials: H
authors.lastname: Decraemer
authors.forename: Katarina
authors.initials: K
authors.lastname: Någga
authors.forename: Lennart
authors.initials: L
authors.lastname: Minthon
authors.forename: Elisabet
authors.initials: E
authors.lastname: Londos
authors.forename: Eugeen
authors.initials: E
authors.lastname: Vanmechelen
authors.forename: Björn
authors.initials: B
authors.lastname: Holmberg
authors.forename: Henrik
authors.initials: H
authors.lastname: Zetterberg
authors.forename: Kaj
authors.initials: K
authors.lastname: Blennow
authors.forename: Oskar
authors.initials: O
authors.lastname: Hansson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000134:cerebrospinal fluid* / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006454:Hemoglobins / Q000134:cerebrospinal fluid; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000134:cerebrospinal fluid / Q000175:diagnosis; D019636:Neurodegenerative Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000134:cerebrospinal fluid* / Q000150:complications / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013494:Supranuclear Palsy, Progressive / Q000134:cerebrospinal fluid / Q000175:diagnosis; D051844:alpha-Synuclein / Q000134:cerebrospinal fluid; D016875:tau Proteins / Q000134:cerebrospinal fluid
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers; D006454:Hemoglobins; D051844:alpha-Synuclein; D016875:tau Proteins