From Cerebrospinal Fluid Neurochemistry to Clinical Diagnosis of Alzheimer’s Disease in the Era of Anti-Amyloid Treatments. Report of Four Patients
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patients
2.2. Neuropsychological Approach
2.3. Neuroimaging
2.4. Lumbar Puncture and CSF Biomarker Measurements
3. Results
3.1. Patient 1
3.2. Patient 2
3.3. Patient 3
3.4. Patient 4
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Patient 1 | Patient 2 | Patient 3 | Patient 4 | |
---|---|---|---|---|
Gender | Female | Female | Male | Female |
Age (years) | 76 | 76 | 81 | 83 |
Education (years) | 6 | 12 | 12 | 12 |
Disease duration (years) | 4 | 3 | 4 | 3 |
ACE-R [37] | 77/100 | 51/100 | 49/100 | 44/100 |
MMSE [38] | 29/30 | 23/30 | 15/30 | 14/30 |
IADL [39] | 7/8 | 8/8 | 3/8 | 2/8 |
5-words delayed recall [40] | 2 + 3/5 | 0 + 0/5 | 0 + 2/5 | 1 + 1/5 |
FAB [41] | 9/18 | 10/18 | 5/18 | 3/18 |
CLOX1 [42] | 9/15 | 12/15 | 0/15 | 4/15 |
CLOX2 [42] | 10/15 | 12/15 | 0/15 | 6/15 |
GDS [43] | 5/15 | 4/15 | 3/15 | 2/15 |
CDR sum of boxes [44] | 1 | 0 | 10 | 12 |
CDR overall [44] | 0.5 | 0 | 2 | 2 |
Clinical diagnosis | Incipient dementia (frontal-like?) | PPA logopenic | NPH; VCI | CBS-like; VCI; NPH (?) |
Aβ42 (pg/mL) (normal > 500) | 492.8 ↓ | 864.5 | 262.1 ↓ | 627.9 |
Aβ40 (pg/mL) | 13938 | 12185 | NA | 11648 |
Aβ42/Aβ40 (normal > 0.09) | 0.035 ↓ | 0.071 ↓ | NA | 0.054 ↓ |
τP-181 (pg/mL) (normal < 60) | 161.6 ↑ | 110.1 ↑ | 62.3 ↑ | 82.6 ↑ |
τT (pg/mL) (normal < 400) | 557.7 ↑ | 490.5 ↑ | 420.1 ↑ | 427.1 ↑ |
AT(N) profile [18] | A+T+(N)+ | A+T+(N)+ | A+T+(N)+ | A+T+(N)+ |
Final diagnosis | AD | AD | NPH + VCI + AD | AD mixed |
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Tsantzali, I.; Boufidou, F.; Sideri, E.; Mavromatos, A.; Papaioannou, M.G.; Foska, A.; Tollos, I.; Paraskevas, S.G.; Bonakis, A.; Voumvourakis, K.I.; et al. From Cerebrospinal Fluid Neurochemistry to Clinical Diagnosis of Alzheimer’s Disease in the Era of Anti-Amyloid Treatments. Report of Four Patients. Biomedicines 2021, 9, 1376. https://doi.org/10.3390/biomedicines9101376
Tsantzali I, Boufidou F, Sideri E, Mavromatos A, Papaioannou MG, Foska A, Tollos I, Paraskevas SG, Bonakis A, Voumvourakis KI, et al. From Cerebrospinal Fluid Neurochemistry to Clinical Diagnosis of Alzheimer’s Disease in the Era of Anti-Amyloid Treatments. Report of Four Patients. Biomedicines. 2021; 9(10):1376. https://doi.org/10.3390/biomedicines9101376
Chicago/Turabian StyleTsantzali, Ioanna, Fotini Boufidou, Eleni Sideri, Antonis Mavromatos, Myrto G. Papaioannou, Aikaterini Foska, Ioannis Tollos, Sotirios G. Paraskevas, Anastasios Bonakis, Konstantinos I. Voumvourakis, and et al. 2021. "From Cerebrospinal Fluid Neurochemistry to Clinical Diagnosis of Alzheimer’s Disease in the Era of Anti-Amyloid Treatments. Report of Four Patients" Biomedicines 9, no. 10: 1376. https://doi.org/10.3390/biomedicines9101376