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Erschienen in: Journal of Neurology 7/2019

08.04.2019 | Original Communication

Amyloid PETs are commonly negative in suspected Alzheimer’s disease with an increase in CSF phosphorylated-tau protein concentration but an Aβ42 concentration in the very high range: a prospective study

verfasst von: Chloé Manca, Thérèse Rivasseau Jonveaux, Véronique Roch, Pierre-Yves Marie, Gilles Karcher, Zohra Lamiral, Catherine Malaplate, Antoine Verger

Erschienen in: Journal of Neurology | Ausgabe 7/2019

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Abstract

Background

Atypical cerebrospinal fluid (CSF) patterns, involving an increase in the concentration of phosphorylated-tau (P-tau) proteins but normal amyloid-β concentration, are not uncommon in patients with mild neurocognitive disorders and suspected Alzheimer’s disease (AD). In these conditions, however, AD diagnosis may be ruled out in the absence of any amyloid deposition at positron-emission tomography (PET). This pilot cross-sectional study was aimed to determine whether this negativity of amyloid PET can be predicted by CSF profiles in such patients.

Methods

Twenty-five patients (73 [68–80] years, 10 women) with mild neurocognitive disorders, suspected AD and an increase in the CSF concentration of P-tau proteins but normal Aβ42 concentration and Aβ42/Aβ40 ratio were prospectively included and referred to a 18F-florbetaben PET. The latter was considered as definitively negative with the conjunction of both visual (brain amyloid plaque load score) and quantified (standard uptake value ratios) criteria. Predictors of a negative PET were searched among current CSF biomarkers (Aß42, Aß40, T-tau, P-tau, Aß42/Aß40, Aß42/p-tau).

Results

Amyloid PET was negative in 15 patients (60%) with a CSF Aß42 concentration being the sole independent predictor of this negativity. The criterion of an Aß42 concentration in the very high range (> 843 pg/mL), observed in 60% (15/25) of the study patients, was associated with a negative amyloid PET in 93% (14/15) of cases.

Conclusions

In mild neurocognitive disorders patients with suspected AD and showing an increase in CSF P-tau protein level, amyloid PETs are commonly negative, when Aß42 concentration is in the very high range. In such case, AD diagnosis based on biomarkers can be ruled out with reasonable certainty, without the need for additional CSF second-line assays or results from amyloid PET.
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Literatur
3.
Zurück zum Zitat Sauvée M, DidierLaurent G, Latarche C et al (2014) Additional use of Aβ42/Aβ40 ratio with cerebrospinal fluid biomarkers P-tau and Aβ42 increases the level of evidence of Alzheimer’s disease pathophysiological process in routine practice. J Alzheimers Dis JAD 41:377–386. https://doi.org/10.3233/JAD-131838 CrossRefPubMed Sauvée M, DidierLaurent G, Latarche C et al (2014) Additional use of Aβ42/Aβ40 ratio with cerebrospinal fluid biomarkers P-tau and Aβ42 increases the level of evidence of Alzheimer’s disease pathophysiological process in routine practice. J Alzheimers Dis JAD 41:377–386. https://​doi.​org/​10.​3233/​JAD-131838 CrossRefPubMed
12.
Zurück zum Zitat American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub, Washington DCCrossRef American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub, Washington DCCrossRef
13.
Zurück zum Zitat McKhann GM, Knopman DS, Chertkow H et al (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement J Alzheimers Assoc 7:263–269. https://doi.org/10.1016/j.jalz.2011.03.005 CrossRef McKhann GM, Knopman DS, Chertkow H et al (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement J Alzheimers Assoc 7:263–269. https://​doi.​org/​10.​1016/​j.​jalz.​2011.​03.​005 CrossRef
14.
Zurück zum Zitat McKhann G, Drachman D, Folstein M et al (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 34:939–944CrossRefPubMed McKhann G, Drachman D, Folstein M et al (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 34:939–944CrossRefPubMed
23.
Zurück zum Zitat Morris JC (1993) The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 43:2412–2414CrossRefPubMed Morris JC (1993) The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 43:2412–2414CrossRefPubMed
Metadaten
Titel
Amyloid PETs are commonly negative in suspected Alzheimer’s disease with an increase in CSF phosphorylated-tau protein concentration but an Aβ42 concentration in the very high range: a prospective study
verfasst von
Chloé Manca
Thérèse Rivasseau Jonveaux
Véronique Roch
Pierre-Yves Marie
Gilles Karcher
Zohra Lamiral
Catherine Malaplate
Antoine Verger
Publikationsdatum
08.04.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 7/2019
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-019-09315-y

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