TY - JOUR
T1 - Use of Alzheimer's Disease Cerebrospinal Fluid Biomarkers in A Tertiary Care Memory Clinic
AU - Stiffel, Michael
AU - Bergeron, David
AU - Mourabit Amari, Karim
AU - Poulin, Élizabeth
AU - Roberge, Xavier
AU - Meilleur-Durand, Synthia
AU - Sellami, Leila
AU - Molin, Pierre
AU - Nadeau, Yannick
AU - Fortin, Marie-Pierre
AU - Caron, Stéphanie
AU - Poulin, Stéphane
AU - Verret, Louis
AU - Bouchard, R. mi W.
AU - Teunissen, Charlotte
AU - Laforce, Robert Jr
N1 - Funding Information: The authors wish to thank the Primary Progressive Aphasia Research Chair – Lemaire Family Fund at Université Laval and the Vanier Graduate Scholarship of the Canadian Institutes of Health Research (CIHR) for funding this research. Publisher Copyright: © 2022 Cambridge University Press. All rights reserved.
PY - 2022/3/13
Y1 - 2022/3/13
N2 - INTRODUCTION: Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers are promising tools to help identify the underlying pathology of neurocognitive disorders. In this manuscript, we report our experience with AD CSF biomarkers in 262 consecutive patients in a tertiary care memory clinic. METHODS: We retrospectively reviewed 262 consecutive patients who underwent lumbar puncture (LP) and CSF measurement of AD biomarkers (Aβ1-42, total tau or t-tau, and p-tau181). We studied the safety of the procedure and its impact on patient's diagnosis and management. RESULTS: The LP allowed to identify underlying AD pathology in 72 of the 121 patients (59%) with early onset amnestic mild cognitive impairment (aMCI) with a high probability of progression to AD; to distinguish the behavioral/dysexecutive variant of AD from the behavioral variant of frontotemporal dementia (bvFTD) in 25 of the 45 patients (55%) with an atypical neurobehavioral profile; to identify AD as the underlying pathology in 15 of the 27 patients (55%) with atypical or unclassifiable primary progressive aphasia (PPA); and to distinguish AD from other disorders in 9 of the 29 patients (31%) with psychiatric differential diagnoses and 19 of the 40 patients (47%) with lesional differential diagnoses (normal pressure hydrocephalus, encephalitis, prion disease, etc.). No major complications occurred following the LP. INTERPRETATION: Our results suggest that CSF analysis is a safe and effective diagnostic tool in select patients with neurocognitive disorders. We advocate for a wider use of this biomarker in tertiary care memory clinics in Canada.
AB - INTRODUCTION: Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers are promising tools to help identify the underlying pathology of neurocognitive disorders. In this manuscript, we report our experience with AD CSF biomarkers in 262 consecutive patients in a tertiary care memory clinic. METHODS: We retrospectively reviewed 262 consecutive patients who underwent lumbar puncture (LP) and CSF measurement of AD biomarkers (Aβ1-42, total tau or t-tau, and p-tau181). We studied the safety of the procedure and its impact on patient's diagnosis and management. RESULTS: The LP allowed to identify underlying AD pathology in 72 of the 121 patients (59%) with early onset amnestic mild cognitive impairment (aMCI) with a high probability of progression to AD; to distinguish the behavioral/dysexecutive variant of AD from the behavioral variant of frontotemporal dementia (bvFTD) in 25 of the 45 patients (55%) with an atypical neurobehavioral profile; to identify AD as the underlying pathology in 15 of the 27 patients (55%) with atypical or unclassifiable primary progressive aphasia (PPA); and to distinguish AD from other disorders in 9 of the 29 patients (31%) with psychiatric differential diagnoses and 19 of the 40 patients (47%) with lesional differential diagnoses (normal pressure hydrocephalus, encephalitis, prion disease, etc.). No major complications occurred following the LP. INTERPRETATION: Our results suggest that CSF analysis is a safe and effective diagnostic tool in select patients with neurocognitive disorders. We advocate for a wider use of this biomarker in tertiary care memory clinics in Canada.
KW - Alzheimers
KW - Behavioral Neurology
KW - Biomarker
KW - Cerebrospinal Fluid
KW - FDG-PET
KW - Neuropsychology
UR - http://www.scopus.com/inward/record.url?scp=85126389316&partnerID=8YFLogxK
U2 - https://doi.org/10.1017/cjn.2021.67
DO - https://doi.org/10.1017/cjn.2021.67
M3 - Article
C2 - 33845924
SN - 0317-1671
VL - 49
SP - 203
EP - 209
JO - Canadian Journal of Neurological Sciences
JF - Canadian Journal of Neurological Sciences
IS - 2
ER -