The utility of cerebrospinal fluid biomarkers of Alzheimer’s disease and the APOE genotype in the characterisation of mild cognitive impairment and prodromal Alzheimer’s disease

Author(s): Daniel Apolinar Garcia-Estevez*

Introduction: The use of biomarkers (β-amyloid peptide and Tau protein) in the cerebrospinal fluid (CSF) is useful to identify patients with mild cognitive impairment (MCI) due to Alzheimer’s disease (AD). Other variables, such as a family history of dementia, medial temporal atrophy (MTA) and the ApoE genotype can also help characterize patients with MCI due to AD.

Aim: To identify, using CSF biomarkers for AD in a series of patients with amnestic MCI, those with true prodromal AD and the variables that characterize them.

Subjects and Methods: Forty-one patients with amnestic MCI were studied and evaluated using the memory alteration test (MAT). Biomarkers for AD were determined in the CSF, and the patients classified as having amnestic MCI due to AD if the Hulstaert index was ≤ 1.0 and levels of phosphorylated tau protein ≥ 61 pg/mL. MTA was assessed by MRI using Scheltens visual rating scale. All patients were found to have the ApoE genotype.

Results: Thirty of the patients were classified as having MCI due to AD. Compared with cases that were not due to AD, no significant differences were found with regard to age, sex, family history of dementia, MAT score or MTA measured with the visual rating scale. The group with MCI due to AD had a higher prevalence of the ε4 allele (63.3% vs. 18.2%, p=0.012).

Conclusions: Amnestic MCI can be classified as prodromal AD based on CSF biomarkers and the ApoE genotype, but not based on the assessment of MTA using a visual rating scale.

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