CSF Aβ40 and P-tau181 might differentiate atypical from typical AD phenotypes: preliminary evidence

Neurodegenerative Diseases

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Article / Publication Details Abstract

Objectives. This study aimed at testing whether CSF levels of amyloid β42 (Aβ42), Aβ40, total tau and phosphorylated tau (P-tau181) individually contribute to the identification of atypical phenotypes among a retrospective cohort of probable AD patients diagnosed by means of the ratio between Aβ42 and Aβ40 (Aβ42/40). Methods. The retrospective study cohort comprised 50 probable AD patients diagnosed by means of the ratio between Aβ42 and Aβ40 (Aβ42/40) and for whom total tau and P-tau181 values were also available. Patients were clinically classified as typical, amnestic-predominant AD (N=39; 16 males; mean age: 73.4±7.6 years; mean disease duration: 27.4±24.7 months) or atypical phenotypes (N=11; 6 males; mean age: 70.2±6.5 years; mean disease duration: 35.5±24.9 months) – i.e., posterior cortical atrophy (PCA; N=4), logopenic-variant primary progressive aphasia (lvPPA; N=4) and behavioural-variant AD (bvAD; N=3). A logistic regression allowed to predict the occurrence of atypical vs. typical phenotypes based on age, sex, and Aβ42, Aβ40, total tau and P-tau181 levels. Results. Atypical and typical AD patients were comparable for Aβ42/40 values. Only Aβ40 and P-tau181 levels positively (p=.015) and negatively (p=.019) predicted the occurrence of atypical AD phenotypes, respectively. Classification precision was of 86%, yielding excellent specificity (94.9%), but poor sensitivity (54.5%). Conclusions. The present study delivers promising, albeit preliminary, evidence on the utility of Aβ40 and P-tau181 CSF biomarkers in differentiating atypical from typical Aβ42/40-confirmed AD phenotypes, prompting further research and confirmation on larger cohorts.

S. Karger AG, Basel

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