在患有轻度认知障碍的患者中,CSF生物标志物和初始阿尔茨海默病
Niklas Mattsson1, Henrik Zetterberg, Oskar Hansson
1Institute of Neuroscience and Physiology, Department of Neurochemistry and Psychiatry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden. niklas.mattsson@neuro.gu.se
JAMA
|July 23, 2009
概括
脑脊液 (CSF) 的生物标志物,如β-粉样蛋白1-42 (Abeta42),总 (T-tau) 和酸化 (P-tau),可以在轻度认知障碍 (MCI) 患者中早期识别阿尔茨海默病 (AD). 然而,准确性低于单中心研究,表明需要测试标准化.
科学领域:
- 神经学 神经学
- 生物标志物研究 生物标志物研究
- 阿尔茨海默氏症疾病的诊断方法
背景情况:
- 单中心研究表明,脑脊液 (CSF) 生物标志物可以在轻度认知障碍 (MCI) 患者中识别初始阿尔茨海默病 (AD).
- 缺乏大型的多中心验证研究.
- 这项研究旨在弥合这一差距.
研究的目的:
- 评估CSFβ-粉样蛋白{1-42} (Abeta42),总 (T-) 和酸化 (P-) 的诊断准确性,以预测MCI患者的初始AD.
- 为这些生物标志物建立可靠的切断点.
主要方法:
- 一项两部分的研究:横截面 (AD患者和对照组) 设定截止点,随后对MCI患者进行前性队列研究.
- 在欧洲和美国的12个中心招募了750名MCI患者,529名AD患者和304名对照患者.
- 随访MCI患者至少2年或直到痴呆症诊断.
主要成果:
- 在随访期间,271名MCI患者发展了AD. 在那些患有阿尔茨海默病的人和没有患有阿尔茨海默病的人之间观察到Abeta42,T-tau和P-tau水平的显著差异.
- 在ROC曲线下的面积为Abeta42的0.78,P-tau的0.76,T-tau的0.79.
- 阿贝塔42 / P-tau比率和T-tau的组合实现了83%的灵敏度和72%的特异性,用于识别初始的AD.
结论:
- 脑脊液Abeta42,T-tau和P-tau在识别MCI患者初始AD时表现出很好的准确性.
- 准确性低于以前在单中心研究中报告的.
- 在Abeta42测定中存在显著的位置间变异性,需要对分析技术和临床程序进行标准化.
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