Evaluation of cerebrospinal fluid phosphorylated tau231 as a biomarker in the differential diagnosis of Alzheimer's disease and vascular dementia

摘要

Summary Background The diagnosis of either Alzheimer''s disease ( AD ) or vascular dementia (VaD) is still largely based on clinical guidelines and exclusion of other diseases that may lead to dementia. Aims In this study, we assessed whether the use of sensitive and specific biomarkers such as phosphorylated tau proteins could contribute to an earlier and more accurate diagnosis of AD and VaD, as well as to their differentiation. Material and methods A total of 198 patients, of which 152 had AD , 28 VaD, and 18 were healthy controls ( HC ), were included in the analyses. We analyzed cerebrospinal fluid ( CSF ) levels of total tau protein (t‐tau), tau protein phosphorylated at threonine 231 (p‐tau 231 ), and factor score ( FS ) determined by combination of p‐tau 231 and Mini‐Mental State Examination ( MMSE ) in patients with AD and VaD, as well as in HC . We tested the diagnostic accuracy of these biomarkers in the CSF and FS (p‐tau 231 , MMSE ) in differentiating AD from VaD and HC . Results Total tau levels were significantly elevated in subjects with AD compared to HC , as well as in VaD subjects compared to HC . Discussion p‐tau231 levels were significantly higher in patients with AD vs HC as well in patients with VaD vs HC . p‐tau 231 levels did not distinguish AD from VaD patients. Importantly, FS (p‐tau 231 and MMSE ) showed statistically significant differences in the distribution of subjects with AD and VaD. Conclusion These results indicate that FS (p‐tau 231 and MMSE ) has a strong potential to provide an early distinction between AD and VaD.