Background
Clinical criteria for differentiating Parkinson's disease (PD) with dementia (PDD)
from dementia with Lewy bodies (DLB) are unsatisfactory. Their existence as distinct
clinicopathologic entities is still debated, although the burden of Alzheimer's disease
(AD) pathology seems higher in DLB. Thus, analysis of cerebrospinal fluid (CSF) biomarkers
(β-amyloid1–42 [Aβ42], total tau, and hyperphosphorylated tau [p-tau]) in living subjects might
provide significant pathophysiological information on these diseases.
Methods
Cerebrospinal fluid biomarkers were measured in DLB (n = 19), PDD (n = 18), and AD (n = 23) subjects matched for age, sex, and dementia severity, as well as in PD (n = 20) and normal control subjects (n = 20).
Results
DLB showed the lowest mean CSF Aβ42 levels, with a negative association to dementia
duration (ρ = −.42, p = .07). In DLB patients, mean CSF total tau levels were significantly lower than
in AD patients (508 ± 387 vs. 960 ± 619, respectively) but twofold to threefold higher
than in PDD (286 ± 184), PD (160 ± 64), or normal control subjects (177 ± 76), with
a positive association to dementia severity (Mini-Mental State Examination: ρ = −.54,
p = .02; Milan Overall Dementia Assessment: ρ = −.66, p = .002). PDD patients had mean CSF Aβ42 and total tau levels similar to those seen
in PD patients. Hyperphosphorylated tau was significantly increased in the AD group
only.
Conclusions
Cerebrospinal fluid Aβ42 and total tau have a different behavior in DLB and PDD, being
related to duration and severity of dementia in DLB alone. Hyperphosphorylated tau
is not significantly altered in these conditions.
Key Words
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Article info
Publication history
Published online: April 07, 2008
Accepted:
February 26,
2008
Received in revised form:
February 25,
2008
Received:
July 12,
2007
Identification
Copyright
© 2008 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
