title: A comparison of early diagnostic utility of Alzheimer disease biomarkers in brain magnetic resonance and cerebrospinal fluid.
abstract: BACKGROUND
  The goals of this study were to compare the early diagnostic utility of Alzheimer disease biomarkers in the CSF with those in brain MRI in conditions found in our clinical practice, and to ascertain the diagnostic accuracy of both techniques used together.
  
  
  METHODS
  Between 2008 and 2009, we included 30 patients with mild cognitive impairment (MCI) who were examined using 1.5 Tesla brain MRI and AD biomarker analysis in CSF. MRI studies were evaluated by 2 radiologists according to the Korf́s visual scale. CSF biomarkers were analysed using INNOTEST reagents for Aβ1-42, total-tau and phospho-tau181p. We evaluated clinical changes 2 years after inclusion.
  
  
  RESULTS
  By 2 years after inclusion, 15 of the original 30 patients (50%) had developed AD (NINCDS-ADRA criteria). The predictive utility of AD biomarkers in CSF (RR 2.7; 95% CI, 1.1-6.7; P<.01) was greater than that of MRI (RR 1.5; 95% CI 95%, 0.7-3.4; P<.2); using both techniques together yielded a sensitivity and a negative predictive value of 100%. Normal results on both complementary tests ruled out progression to AD (100%) within 2 years of inclusion.
  
  
  CONCLUSIONS
  Our results show that the diagnostic accuracy of biomarkers in CSF is higher than that of biomarkers in MRI. Combined use of both techniques is highly accurate for either early diagnosis or exclusion of AD in patients with MCI.
authors: Servicio de Neurología, Hospital General Universitario de Alicante, Alicante, España. Electronic address: monge_jos@gva.es.
authors: J A
authors: JA
authors: Monge Argilés
authors: Servicio de Neurología, Hospital General Universitario de Alicante, Alicante, España.
authors: M A
authors: MA
authors: Blanco Cantó
authors: Servicio de Radiología, Hospital General Universitario La Fe, Valencia, España.
authors: C
authors: C
authors: Leiva Salinas
authors: Servicio de Radiología, Hospital General Universitario La Fe, Valencia, España.
authors: L
authors: L
authors: Flors
authors: Laboratorio de Inmunología. Hospital General Universitario de Alicante, Alicante, España.
authors: C
authors: C
authors: Muñoz Ruiz
authors: Servicio de Medicina Preventiva, Hospital General Universitario de Alicante, Alicante, España.
authors: J
authors: J
authors: Sánchez Payá
authors: Servicio de Neurología, Hospital General Universitario de Alicante, Alicante, España.
authors: R
authors: R
authors: Gasparini Berenguer
authors: Servicio de Neurología, Hospital General Universitario de Alicante, Alicante, España.
authors: C
authors: C
authors: Leiva Santana
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D001921:Brain / Q000473:pathology*; D060825:Cognitive Dysfunction / Q000175:diagnosis; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers
keywords: Alzheimer disease; Biomarcadores; Biomarkers; Brain magnetic resonance; Cerebrospinal fluid; Deterioro cognitivo leve; Diagnóstico precoz; Early diagnosis; Enfermedad de Alzheimer; Líquido cefalorraquídeo; Mild cognitive impairment; Resonancia magnética