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Cerebrospinal fluid tau protein and periventricular white matter lesions in patients with mild cognitive impairment:

Masahiro Maruyama1, Toshifumi Matsui, Haruko Tanji

  • 1Department of Geriatric Medicine, Tohoku University School of Medicine, Sendai, Miyagi, Japan.

Archives of Neurology
|May 19, 2004
PubMed
Abstract

Insights

Mild cognitive impairment (MCI) is heterogeneous. Biomarkers like cerebrospinal fluid tau and white matter lesions help identify progressive MCI, aiding Alzheimer

Area of Science:

  • Neurology
  • Neuroscience
  • Geriatrics

Background:

  • Mild cognitive impairment (MCI) is increasingly recognized as a heterogeneous condition, not a singular disease entity.
  • Understanding this heterogeneity is crucial for developing targeted interventions for Alzheimer's disease (AD).

Purpose of the Study:

  • To develop tools for identifying individuals with MCI who are at high risk of progressing to Alzheimer's disease (AD).
  • To differentiate between subtypes of MCI to better target emerging AD therapies.

Main Methods:

  • A 2-year prospective study involving 72 older patients with memory complaints.
  • Assessment of baseline biomarkers including cerebrospinal fluid tau, white matter lesions (periventricular and deep), silent brain infarction, plasma homocysteine, and apolipoprotein E genotype.
  • Clinical follow-up in an outpatient memory clinic to track cognitive progression.

Main Results:

  • Fifty-seven patients were diagnosed with amnestic MCI, with 41 progressing to dementia/AD and 16 remaining stable.
  • Stable MCI was associated with normal cerebrospinal fluid tau and high periventricular white matter lesions (PWMLs).
  • Progressive MCI and AD-converted MCI showed increased cerebrospinal fluid tau and low-grade PWMLs. Age was linked to PWML development.

Conclusions:

  • Tau-related pathology and ischemic PWMLs are key etiologies contributing to MCI heterogeneity and progression.
  • Identifying progressive MCI using biomarkers and neuroimaging is vital for secondary dementia prevention trials.
  • This approach can help stratify patients for clinical trials targeting Alzheimer's disease.

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