Comparative analysis of cerebrospinal fluid biomarkers in the differential diagnosis of neurodegenerative dementia

Introduction: The analysis of cerebrospinal fluid biomarkers gains importance in clinical routine and is effective in substantiating dementia diagnosis in the differential diagnostic context. Methods: We evaluated the levels of beta-amyloid (A beta) 42, A beta 40, tau, and P-tau in a large patient population subdivided into prion diseases, tauopathies, synucleinopathies, and controls. Diagnostic test evaluation was assessed by ROC area under the curve analysis. Results: High tau levels were detected in sporadic Creutzfeldt-Jakob disease (sCJD) and high P-tau levels in Alzheimer's disease (AD) and sCJD. A beta 40 was lower exclusively in prionopathies, but low A beta 42 was detected in AD, sCJD, and Lewy body dementia. When disease groups were stratified according to the underlying proteinopathy, we detected disease-type specificities for all biomarkers. P-tau/tau, A beta 42/40, A beta 42/tau, and A beta 40/tau ratios proved valuable in discriminating disease groups and controls, especially P-tau/tau ratio in the identification of sCJD cases. Discussion: Combining the biomarker panel allows differentiating between various types of neuro-degenerative dementias and contributes to a better understanding of their pathophysiological processes. (C) 2015 Alzheimer's Association. Published by Elsevier Inc. All rights reserved.