Urine AD7c-NTP Predicts Amyloid Deposition and Symptom of Agitation in Patients with Alzheimer's Disease and Mild Cognitive Impairment

Background: Expression of neuronal thread protein (NTP), which is considered to be related to neuritic sprouting and neuronal death, may be elevated in brain tissue, cerebrospinal fluid, and even urine in patients with Alzheimer's disease (AD). Objective: In this study, we analyzed the correlation between urine AD-associated NTP (AD7c-NTP) level, and amyloid-beta (A beta) deposition, and clinical symptoms in AD and mild cognitive impairment (MCI). Methods: Twenty-two patients with mild to moderate AD and 8 subjects with MCI were recruited. A beta deposition was measured with [C-11]-labeled Pittsburgh compound B (PiB)-positron emission tomography (PET) in all participants. Urine AD7c-NTP levels were measured using enzyme-linked immunosorbent assay. Mini-Mental State Examination (MMSE) and Neuropsychiatric Inventory (NPI) were used to evaluate cognitive function and behavioral psychological symptoms, respectively. Results: Fourteen (63.6%) ofADpatients and 2 (25.0%) of MCI subjects were A beta positive on PiB-PET. There was a significant difference in urine AD7c-NTP level between A beta positive ( 2.27 +/- 2.22 ng/ml) and negative (0.55 +/- 0.60 ng/ ml) subjects (p = 0.018). Using 1.46 ng/ml as a cut-off value, 68.8% of A beta positive subjects showed elevated urine AD7c-NTP level, and 92.9% of A beta negative subjects showed normal urine AD7c-NTP level. There were no relationships between urine AD7c-NTP level and MMSE and total NPI scores. However, AD7c-NTP level positively correlated with agitation score on NPI. Conclusions: Urine AD7c-NTP had high specificity and moderate sensitivity in predicting A beta deposition among patients with cognitive impairment. Furthermore, urine AD7c-NTP level strongly correlated with the symptom of agitation.