title: Dissociation of amyloid biomarkers in PET and CSF in Alzheimer's disease: a case report.
abstract: BACKGROUND
  Recently, biomarkers have been suggested to be incorporated into diagnostic criteria for Alzheimer's disease (AD). Regarding disease-specific brain amyloid-beta deposition these comprise low amyloid-beta 1-42 in cerebrospinal fluid (CSF) and positive positron emission tomography (PET) amyloid imaging, while neuronal degeneration is evidenced by high total and phosphorylated tau levels in CSF (t-/p-tau), regional hypometabolism ([(18)F]fluorodeoxyglucose PET, FDG-PET) and characteristic atrophy-patterns (magnetic resonance imaging, MRI).
  
  
  METHODS
  Here we present a case of clinically and biomarker supported AD (CSF t-/p-tau, MRI, FDG-PET) in a 59-year-old Caucasian man in whom indicators of amyloid-beta deposition dissociated between CSF parameters and the respective PET imaging.
  
  
  CONCLUSIONS
  Such cases highlight the necessity to better understand potential dissociations between PET and CSF data for amyloid-beta biomarkers, because they are currently considered interchangeably valid with regard to in-vivo evidence for AD pathology. This is more important since amyloid deposition markers can be considered a very first prognostic indicator of imminent AD, prior to neurodegenerative biomarkers and cognitive symptoms. The case illustrates the need for further longitudinal data on potential dissociations of AD biomarkers to devise recommendations for their better prognostic and diagnostic interpretation in the future.
authors: Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1A & Clinic for Cognitive Neurology, University of Leipzig, Liebigstr. 16 04103, Leipzig, Germany. schroet@cbs.mpg.de.|Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany. schroet@cbs.mpg.de.|Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany. schroet@cbs.mpg.de.|German Consortium for Frontotemporal Lobar Degeneration, Ulm, Germany. schroet@cbs.mpg.de.
authors: Matthias L
authors: ML
authors: Schroeter
authors: Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany. solveig.tiepolt@medizin.uni-leipzig.de.
authors: Solveig
authors: S
authors: Tiepolt
authors: Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany. anke.marschhauser@medizin.uni-leipzig.de.
authors: Anke
authors: A
authors: Marschhauser
authors: Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany. angelika.thoene@medizin.uni-leipzig.de.
authors: Angelika
authors: A
authors: Thöne-Otto
authors: Department of Neuroradiology, University of Leipzig, Leipzig, Germany. karl-titus.hoffmann@medizin.uni-leipzig.de.
authors: Karl-Titus
authors: KT
authors: Hoffmann
authors: Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany. henryk.barthel@medizin.uni-leipzig.de.
authors: Henryk
authors: H
authors: Barthel
authors: Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1A & Clinic for Cognitive Neurology, University of Leipzig, Liebigstr. 16 04103, Leipzig, Germany. obrig@cbs.mpg.de.|Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany. obrig@cbs.mpg.de.
authors: Hellmuth
authors: H
authors: Obrig
authors: Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany. osama.sabri@medizin.uni-leipzig.de.
authors: Osama
authors: O
authors: Sabri
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000000981:diagnostic imaging; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid* / Q000378:metabolism; D001284:Atrophy; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000134:cerebrospinal fluid* / Q000378:metabolism; D010766:Phosphorylation; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers; D010446:Peptide Fragments; D019275:Radiopharmaceuticals; C075222:amyloid beta-protein (1-42); D016875:tau Proteins; D019788:Fluorodeoxyglucose F18