title: Increased albumin CSF/serum ratio in dementia with Lewy bodies.
abstract: BACKGROUND
  Alterations in the CSF/serum albumin ratio (Qalb) is currently recognized as one of the most reliable markers of blood-brain barrier impairment and blood-CSF barrier permeability, but its potential role as a biomarker in the differential diagnosis of neurological diseases has been poorly analysed.
  
  
  METHODS
  We evaluated Qalb and core CSF biomarkers (Tau, p-Tau and Aβ42) in a large patient population of neurological and neurodegenerative cases. Diagnostic test evaluation was assessed by ROC-AUC analysis.
  
  
  RESULTS
  In the differential diagnostic analysis, increased Qalb was found in dementia with Lewy bodies (DLB) patients compared to other diseases, either individually or stratified in non-dementia and dementia groups. When clinical groups were analysed individually and compared to controls, Qalb was also increased in stroke and Parkinson's disease dementia (PDD) cases, but not in Parkinson's disease (PD). Qalb in DLB cases correlate with CSF Aβ42 levels but not with Tau and p-Tau levels. Due to the lower CSF Aβ42 levels in DLB compared to PD and PDD, the potential clinical applicability of Qalb with respect to the DLB diagnosis is increased in combination with CSF Aβ42 analysis.
  
  
  CONCLUSIONS
  The present study demonstrates increased Qalb in synucleinopathies associated with dementia revealing a potential new clinical approach for the differential diagnosis of DLB.
authors.affiliation: Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany. Electronic address: franc.llorens@gmail.com.
authors.forename: Franc
authors.initials: F
authors.lastname: Llorens
authors.affiliation: Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schmitz
authors.affiliation: Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany.
authors.forename: Sara Friederike
authors.initials: SF
authors.lastname: Gloeckner
authors.affiliation: Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Kaerst
authors.affiliation: Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Hermann
authors.affiliation: Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schmidt
authors.affiliation: Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Varges
authors.affiliation: Clinical Dementia Center, Department of Neurology, University Medical Center Göttingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.
authors.forename: Inga
authors.initials: I
authors.lastname: Zerr
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000134:cerebrospinal fluid*; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000097:blood* / Q000134:cerebrospinal fluid*; D008297:Male; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D000418:Albumins; D015415:Biomarkers; D012709:Serum Albumin
keywords: Albumin ratio; Aβ42; Biomarker; Cerebrospinal fluid; Dementia; Dementia with Lewy bodies; Neurodegenerative diseases; Synucleinopathies