Addition of MHPG to Alzheimer's disease biomarkers improves differentiation of dementia with Lewy bodies from Alzheimer's disease but not other dementias.
BACKGROUND
Overlapping clinical features make it difficult to distinguish dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) and other dementia types. In this study we aimed to determine whether the combination of cerebrospinal fluid (CSF) biomarkers, amyloid-β42 (Aβ42), total tau protein (t-tau), and phosphorylated tau protein (p-tau), in combination with 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG), could be useful in discriminating DLB from vascular dementia (VaD) and frontotemporal dementia (FTD), as we previously demonstrated for differentiation of DLB from AD.


METHODS
We retrospectively analyzed concentrations of MHPG, Aβ42, t-tau, and p-tau in CSF in patients with DLB, AD, VaD, and FTD. Using previously developed multivariate logistic regression models we assessed the diagnostic value of these CSF parameters.


RESULTS
The currently used combination of Aβ42, t-tau, and p-tau yielded a sensitivity of 61.9% and a specificity of 91.7% for the discrimination between DLB and AD, but could not discriminate between DLB and VaD or FTD. The addition of MHPG to Aβ42, t-tau, and p-tau improves the discrimination of DLB from AD, yielding a sensitivity of 65.1% and specificity of 100%, but could not distinguish DLB from other forms of dementia.


CONCLUSIONS
Our results confirm in a separate patient cohort that addition of MHPG to Aβ42, t-tau, and p-tau improves the discrimination of DLB from AD but not the differentiation of DLB from VaD or FTD.
Department of Neurology, Radboud University Medical Centre, and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud Alzheimer Centre, Nijmegen, The Netherlands; Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.
Megan K
MK
Herbert
Department of Neurology, Radboud University Medical Centre, and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
Marjolein B
MB
Aerts
Department of Neurology, Radboud University Medical Centre, and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud Alzheimer Centre, Nijmegen, The Netherlands; Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.
H Bea
HB
Kuiperij
Department of Neurology, Radboud University Medical Centre, and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Department of Geriatrics, Radboud University Medical Centre, Nijmegen, The Netherlands.
Jurgen A H R
JAHR
Claassen
Radboud Alzheimer Centre, Nijmegen, The Netherlands; Department of Geriatrics, Radboud University Medical Centre, Nijmegen, The Netherlands.
Petra E
PE
Spies
Department of Neurology, Radboud University Medical Centre, and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
Rianne A J
RAJ
Esselink
Department of Neurology, Radboud University Medical Centre, and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
Bastiaan R
BR
Bloem
Department of Neurology, Radboud University Medical Centre, and Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Radboud Alzheimer Centre, Nijmegen, The Netherlands; Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands. Electronic address: m.verbeek@neuro.umcn.nl.
Marcel M
MM
Verbeek
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D016015:Logistic Models; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D008875:Middle Aged; D010446:Peptide Fragments / Q000134:cerebrospinal fluid; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016875:tau Proteins / Q000134:cerebrospinal fluid
D016229:Amyloid beta-Peptides; D015415:Biomarkers; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42); D016875:tau Proteins; D008734:Methoxyhydroxyphenylglycol
Alzheimer's disease; CSF biomarkers; Dementia with Lewy bodies; Differential diagnosis; Frontotemporal dementia; Vascular dementia