Novel diagnostic cerebrospinal fluid biomarkers for pathologic subtypes of frontotemporal dementia identified by proteomics

Charlotte E. Teunissen, Naura Elias, Marleen J A Koel-Simmelink, Sisi Durieux-Lu, Arjan Malekzadeh, Thang V. Pham, Sander R. Piersma, Tommaso Beccari, Lieke H H Meeter, Elise G P Dopper, John C. van Swieten, Connie R. Jimenez, Yolande A L Pijnenburg

Research output: Contribution to journalArticleAcademicpeer-review

70 Citations (Scopus)


Introduction: Reliable cerebrospinal fluid (CSF) biomarkers enabling identification of frontotemporal dementia (FTD) and its pathologic subtypes are lacking. Methods: Unbiased high-resolution mass spectrometry-based proteomics was applied on CSF of FTD patients with TAR DNA-binding protein 43 (TDP-43, FTD-TDP, n = 12) or tau pathology (FTD-tau, n = 8), and individuals with subjective memory complaints (SMC, n = 10). Validation was performed by applying enzyme-linked immunosorbent assay (ELISA) or enzymatic assays, when available, in a larger cohort (FTLD-TDP, n = 21, FTLD-tau, n = 10, SMC, n = 23) and in Alzheimer's disease (n = 20), dementia with Lewy bodies (DLB, n = 20), and vascular dementia (VaD, n = 18). Results: Of 1914 identified CSF proteins, 56 proteins were differentially regulated (fold change >1.2, P <.05) between the different patient groups: either between the two pathologic subtypes (10 proteins), or between at least one of these FTD subtypes and SMC (47 proteins). We confirmed the differential expression of YKL-40 by ELISA in a partly independent cohort. Furthermore, enzyme activity of catalase was decreased in FTD subtypes compared with SMC. Further validation in a larger cohort showed that the level of YKL-40 was twofold increased in both FTD pathologic subtypes compared with SMC and that the levels in FTLD-tau were higher compared to Alzheimer's dementia (AD), DLB, and VaD patients. Clinical validation furthermore showed that the catalase enzyme activity was decreased in the FTD subtypes compared to SMC, AD and DLB. Discussion: We identified promising CSF biomarkers for both FTD differential diagnosis and pathologic subtyping. YKL-40 and catalase enzyme activity should be validated further in similar pathology defined patient cohorts for their use for FTD diagnosis or treatment development.

Original languageEnglish
Pages (from-to)86-94
Number of pages9
JournalAlzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Publication statusPublished - 2016


  • Biomarkers
  • Cerebrospinal fluid
  • Differential diagnosis
  • Frontotemporal dementia
  • Pathology
  • Proteomics
  • TDP-43
  • Tau

Cite this