Cerebrospinal Fluid Classical Biomarker Levels in Mixed vs. Pure A<sup>+</sup>T<sup>+</sup> (A<sup>+</sup>T<sub>1</sub><sup>+</sup>) Alzheimer’s Disease

<b>Background</b>: Alzheimer’s disease (AD) may present with pure (typical or atypical) and mixed phenotypes, sometimes causing difficulties in (differential) diagnosis. In order to achieve a diagnostic accuracy as high as possible, the diagnosis of AD during life depends on various biom...

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Main Authors: Ioanna Tsantzali, Athanasia Athanasaki, Fotini Boufidou, Vasilios C. Constantinides, Maria-Ioanna Stefanou, Christos Moschovos, Christina Zompola, Sotirios G. Paraskevas, Anastasios Bonakis, Sotirios Giannopoulos, Georgios Tsivgoulis, Elisabeth Kapaki, George P. Paraskevas
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Language:English
Published: MDPI AG 2024-12-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/12/12/2904
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author Ioanna Tsantzali
Athanasia Athanasaki
Fotini Boufidou
Vasilios C. Constantinides
Maria-Ioanna Stefanou
Christos Moschovos
Christina Zompola
Sotirios G. Paraskevas
Anastasios Bonakis
Sotirios Giannopoulos
Georgios Tsivgoulis
Elisabeth Kapaki
George P. Paraskevas
author_facet Ioanna Tsantzali
Athanasia Athanasaki
Fotini Boufidou
Vasilios C. Constantinides
Maria-Ioanna Stefanou
Christos Moschovos
Christina Zompola
Sotirios G. Paraskevas
Anastasios Bonakis
Sotirios Giannopoulos
Georgios Tsivgoulis
Elisabeth Kapaki
George P. Paraskevas
author_sort Ioanna Tsantzali
collection DOAJ
description <b>Background</b>: Alzheimer’s disease (AD) may present with pure (typical or atypical) and mixed phenotypes, sometimes causing difficulties in (differential) diagnosis. In order to achieve a diagnostic accuracy as high as possible, the diagnosis of AD during life depends on various biomarkers, including the cerebrospinal fluid (CSF) biomarkers. <b>Methods</b>: Classical CSF AD biomarkers were determined in a total of 61 patients, classified as both beta amyloid- and tau-positive A<sup>+</sup>T<sup>+</sup> (or A<sup>+</sup>T<sub>1</sub><sup>+</sup> according to the recently revised Alzheimer Association criteria for diagnosis and staging of AD). Twenty one of these patients fulfilled the criteria for mixed AD (mixed with Lewy bodies, cerebrovascular disease, or normal pressure hydrocephalus), whilst 40 had pure AD. Results: Patients did not differ with respect to gender, education, disease duration, and cognitive status. After controlling for confounding factors, no difference was observed between mixed and pure AD groups in Aβ<sub>42</sub> or Aβ<sub>42</sub>/Aβ<sub>40</sub> levels. Although by definition, patients of both groups had abnormal (increased) levels of phospho-tau<sub>181</sub>, the mixed AD group presented with lower (less abnormal) levels of phospho-tau181 and total tau as compared to the pure group. Conclusions: In patients with AD of comparable cognitive status, mixed AD cases may present with lower levels of tau proteins and, if close to the cut-off values, diagnostic uncertainty may be increased.
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spelling doaj-art-99901959390d4311aee386fe2e6ec7692025-08-20T02:53:27ZengMDPI AGBiomedicines2227-90592024-12-011212290410.3390/biomedicines12122904Cerebrospinal Fluid Classical Biomarker Levels in Mixed vs. Pure A<sup>+</sup>T<sup>+</sup> (A<sup>+</sup>T<sub>1</sub><sup>+</sup>) Alzheimer’s DiseaseIoanna Tsantzali0Athanasia Athanasaki1Fotini Boufidou2Vasilios C. Constantinides3Maria-Ioanna Stefanou4Christos Moschovos5Christina Zompola6Sotirios G. Paraskevas7Anastasios Bonakis8Sotirios Giannopoulos9Georgios Tsivgoulis10Elisabeth Kapaki11George P. Paraskevas122nd Department of Neurology, “Attikon” General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Neurology, “Attikon” General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceNeurochemistry and Βiological Markers Unit, 1st Department of Neurology, “Eginition” Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, GreeceNeurochemistry and Βiological Markers Unit, 1st Department of Neurology, “Eginition” Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece2nd Department of Neurology, “Attikon” General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Neurology, “Attikon” General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Neurology, “Attikon” General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Neurology, “Attikon” General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Neurology, “Attikon” General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Neurology, “Attikon” General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Neurology, “Attikon” General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceNeurochemistry and Βiological Markers Unit, 1st Department of Neurology, “Eginition” Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece2nd Department of Neurology, “Attikon” General University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece<b>Background</b>: Alzheimer’s disease (AD) may present with pure (typical or atypical) and mixed phenotypes, sometimes causing difficulties in (differential) diagnosis. In order to achieve a diagnostic accuracy as high as possible, the diagnosis of AD during life depends on various biomarkers, including the cerebrospinal fluid (CSF) biomarkers. <b>Methods</b>: Classical CSF AD biomarkers were determined in a total of 61 patients, classified as both beta amyloid- and tau-positive A<sup>+</sup>T<sup>+</sup> (or A<sup>+</sup>T<sub>1</sub><sup>+</sup> according to the recently revised Alzheimer Association criteria for diagnosis and staging of AD). Twenty one of these patients fulfilled the criteria for mixed AD (mixed with Lewy bodies, cerebrovascular disease, or normal pressure hydrocephalus), whilst 40 had pure AD. Results: Patients did not differ with respect to gender, education, disease duration, and cognitive status. After controlling for confounding factors, no difference was observed between mixed and pure AD groups in Aβ<sub>42</sub> or Aβ<sub>42</sub>/Aβ<sub>40</sub> levels. Although by definition, patients of both groups had abnormal (increased) levels of phospho-tau<sub>181</sub>, the mixed AD group presented with lower (less abnormal) levels of phospho-tau181 and total tau as compared to the pure group. Conclusions: In patients with AD of comparable cognitive status, mixed AD cases may present with lower levels of tau proteins and, if close to the cut-off values, diagnostic uncertainty may be increased.https://www.mdpi.com/2227-9059/12/12/2904Alzheimer’s diseasebeta amyloidtau proteinphospho-taucerebrospinal fluidbiomarkers
spellingShingle Ioanna Tsantzali
Athanasia Athanasaki
Fotini Boufidou
Vasilios C. Constantinides
Maria-Ioanna Stefanou
Christos Moschovos
Christina Zompola
Sotirios G. Paraskevas
Anastasios Bonakis
Sotirios Giannopoulos
Georgios Tsivgoulis
Elisabeth Kapaki
George P. Paraskevas
Cerebrospinal Fluid Classical Biomarker Levels in Mixed vs. Pure A<sup>+</sup>T<sup>+</sup> (A<sup>+</sup>T<sub>1</sub><sup>+</sup>) Alzheimer’s Disease
Biomedicines
Alzheimer’s disease
beta amyloid
tau protein
phospho-tau
cerebrospinal fluid
biomarkers
title Cerebrospinal Fluid Classical Biomarker Levels in Mixed vs. Pure A<sup>+</sup>T<sup>+</sup> (A<sup>+</sup>T<sub>1</sub><sup>+</sup>) Alzheimer’s Disease
title_full Cerebrospinal Fluid Classical Biomarker Levels in Mixed vs. Pure A<sup>+</sup>T<sup>+</sup> (A<sup>+</sup>T<sub>1</sub><sup>+</sup>) Alzheimer’s Disease
title_fullStr Cerebrospinal Fluid Classical Biomarker Levels in Mixed vs. Pure A<sup>+</sup>T<sup>+</sup> (A<sup>+</sup>T<sub>1</sub><sup>+</sup>) Alzheimer’s Disease
title_full_unstemmed Cerebrospinal Fluid Classical Biomarker Levels in Mixed vs. Pure A<sup>+</sup>T<sup>+</sup> (A<sup>+</sup>T<sub>1</sub><sup>+</sup>) Alzheimer’s Disease
title_short Cerebrospinal Fluid Classical Biomarker Levels in Mixed vs. Pure A<sup>+</sup>T<sup>+</sup> (A<sup>+</sup>T<sub>1</sub><sup>+</sup>) Alzheimer’s Disease
title_sort cerebrospinal fluid classical biomarker levels in mixed vs pure a sup sup t sup sup a sup sup t sub 1 sub sup sup alzheimer s disease
topic Alzheimer’s disease
beta amyloid
tau protein
phospho-tau
cerebrospinal fluid
biomarkers
url https://www.mdpi.com/2227-9059/12/12/2904
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