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A panel of nine cer...
A panel of nine cerebrospinal fluid biomarkers may identify patients with atypical parkinsonian syndromes
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Magdalinou, N. K. (author)
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Paterson, R. W. (author)
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Schott, J. M. (author)
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Fox, N. C. (author)
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Mummery, C. (author)
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- Blennow, Kaj, 1958 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology
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Bhatia, K. (author)
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Morris, H. R. (author)
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Giunti, P. (author)
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Warner, T. T. (author)
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de Silva, R. (author)
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Lees, A. J. (author)
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Zetterberg, Henrik, 1973 (author)
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(creator_code:org_t)
- 2015-01-14
- 2015
- English.
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In: Journal of Neurology Neurosurgery and Psychiatry. - : BMJ. - 0022-3050 .- 1468-330X. ; 86:11, s. 1240-1247
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Abstract
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- Background Patients presenting with parkinsonian syndromes share many clinical features, which can make diagnosis difficult. This is important as atypical parkinsonian syndromes (APSs) such as progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and corticobasal syndrome (CBS) carry a poor prognosis, compared with patients with Parkinson's disease (PD). In addition, there is overlap between APS and dementia diseases, such as Alzheimer's disease (AD) and frontotemporal dementia (FTD). Objective To use a panel of cerebrospinal fluid (CSF) biomarkers to differentiate patients with APS from PD and dementia. Methods A prospective cohort of 160 patients and 30 control participants were recruited from a single specialist centre. Patients were clinically diagnosed according to current consensus criteria. CSF samples were obtained from patients with clinical diagnoses of PD (n=31), PSP (n=33), CBS (n=14), MSA (n=31), AD (n=26) and FTD (n=16). Healthy, elderly participants (n=30) were included as controls. Total tau (t-tau), phosphorylated tau (p-tau), beta-amyloid 1-42 (A beta 42), neurofilament light chain (NFL), alpha-synuclein (alpha-syn), amyloid precursor protein soluble metabolites alpha and beta (soluble amyloid precursor protein (sAPP)alpha, sAPP beta) and two neuroinflammatory markers (monocyte chemoattractant protein-1 and YKL-40) were measured in CSF. A reverse stepwise regression analysis and the false discovery rate procedure were used. Results CSF NFL (p<0.001), sAPP alpha (p<0.001) and a-syn (p=0.003) independently predicted diagnosis of PD versus APS. Together, these nine biomarkers could differentiate patients with PD from APS with an area under the curve of 0.95 and subtypes of APS from one another. There was good discriminatory power between parkinsonian groups, dementia disorders and healthy controls. Conclusions A panel of nine CSF biomarkers was able to differentiate APS from patients with PD and dementia. This may have important clinical utility in improving diagnostic accuracy, allowing better prognostication and earlier access to potential disease-modifying therapies.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
Keyword
- progressive supranuclear palsy
- richardson-olszewski syndrome
- multiple
- system atrophy
- alpha-synuclein
- clinical-diagnosis
- alzheimers-disease
- rating-scale
- accuracy
- criteria
- ykl-40
- Psychiatry
- Surgery
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Magdalinou, N. K ...
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Paterson, R. W.
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Schott, J. M.
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Fox, N. C.
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Mummery, C.
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Blennow, Kaj, 19 ...
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show more...
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Bhatia, K.
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Morris, H. R.
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Giunti, P.
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Warner, T. T.
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de Silva, R.
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Lees, A. J.
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Zetterberg, Henr ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Neurosciences
- Articles in the publication
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Journal of Neuro ...
- By the university
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University of Gothenburg