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Cerebrospinal Fluid Amyloid ß₄₂/Phosphorylated Tau Ratio Discriminates Between Alzheimer's Disease and Vascular Dementia

¹ Departments of Neurology and ² Geriatric Medicine, ³ Laboratory of Pediatrics and Neurology, Radboud University Nijmegen Medical Centre, The Netherlands.

Address correspondence to Marcel M. Verbeek, PhD, MSc, Radboud University Nijmegen Medical Centre, Laboratory of Pediatrics and Neurology (830 LKN), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: m.verbeek{at}cukz.umcn.nl

Abstract

Background. The differentiation of Alzheimer's disease (AD) from vascular dementia (VaD) is hampered by clinical diagnostic criteria with disappointing sensitivity and specificity. The objective of this study was to investigate whether cerebrospinal fluid (CSF) levels of total tau protein (t-tau), amyloid ß₄₂ protein (Aß₄₂), and tau phosphorylated at threonine 181 (p-tau₁₈₁) are useful biomarkers to distinguish AD patients from VaD patients.

Methods. We measured CSF levels of p-tau₁₈₁, Aß₄₂, and t-tau in 86 patients with a clinical diagnosis of AD or VaD and in 30 control participants.

Results. Optimal differentiation between AD and VaD was achieved by using the ratio of the CSF levels of Aß₄₂ and p-tau₁₈₁ (Q Aß₄₂/p-tau) with sensitivity, specificity, positive and negative predictive values all 85%.

Conclusions. Our results support further efforts to prospectively validate the use of Q Aß₄₂/p-tau as a biomarker to discriminate between AD and VaD.