Format du dépôt |
Fichier |
Type de dépôt |
Article dans une revue |
Titre |
en
Amyloid PETs are commonly negative in suspected Alzheimer’s disease with an increase in CSF phosphorylated-tau protein concentration but an Aβ42 concentration in the very high range: a prospective study
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Résumé |
en
Atypical cerebrospinal fluid (CSF) patterns, involving an increase in the concentration of phosphorylated-tau (P-tau) proteins but normal amyloid-β concentration, are not uncommon in patients with mild neurocognitive disorders and suspected Alzheimer's disease (AD). In these conditions, however, AD diagnosis may be ruled out in the absence of any amyloid deposition at positron emission tomography (PET). This pilot cross-sectional study was aimed to determine whether this negativity of amyloid PET can be predicted by CSF profiles in such patients. Methods: Twenty-five patients (73[68-80] years, 10 women) with mild neurocognitive disorders, suspected AD and an increase in the CSF concentration of P-tau proteins but normal Aβ42 concentration and Aβ42/Aβ40 ratio, were prospectively included and referred to a 18 Fflorbetaben PET. The latter was considered as definitively negative with the conjunction of both visual (brain amyloid plaque load score) and quantified (standard uptake values ratios) criteria. Predictors of a negative PET were searched among current CSF biomarkers (Aß42, Aß40, T-tau, P-tau, Aß42/Aß40, Aß42/p-tau). Results: Amyloid PET was negative in 15 patients (60%) with a CSF Aß42 concentration being the sole independent predictor of this negativity. The criterion of an Aß42 concentration far from the abnormal zone (>843 pg/mL), observed in 60% (15/25) of the study patients, was associated with a negative amyloid PET in 93% (14/15) of cases. Conclusions: In mild neurocognitive disorders patients with suspected AD and showing an increase in CSF P-tau protein level, amyloid PETs are commonly negative, when Aß42 concentration is far from the abnormal zone. In such case, AD diagnosis based on biomarkers can be ruled out with reasonable certainty, without any need of additional CSF second-line assays or results from amyloid PET.
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Auteur(s)
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Chloé Manca
1, 2
, Thérèse Rivasseau Jonveaux
3, 4
, Véronique Roch
1, 2
, Pierre-Yves Marie
1, 2, 5
, Gilles Karcher
1, 2
, Zohra Lamiral
6
, Catherine Malaplate
7
, Antoine Verger
1, 2, 8
1
Service de Médecine Nucléaire [CHRU Nancy]
( 49933 )
- rue du Morvan 54511 Vandoeuvre-lès-Nancy
- France
-
Centre Hospitalier Régional Universitaire de Nancy ( 300157 )
2
Nancyclotep- Experimental Imaging Platform = Plate-forme d'imagerie moléculaire
( 232997 )
- Médecine Nucléaire 5 rue du Morvan – 54500 Vandoeuvre les Nancy
- France
-
Centre Hospitalier Régional Universitaire de Nancy ( 300157 )
;
-
Université de Lorraine ( 413289 )
3
CHRU Nancy -
Centre Hospitalier Régional Universitaire de Nancy
( 300157 )
- Siège social : 29 avenue du Maréchal de Lattre de Tassigny, CO 60034, 54035 NANCY CEDEX
Hôpital Central : 29 Avenue du Maréchal de Lattre de Tassigny, 54035 Nancy
Hôpitaux de Brabois / Enfants : Rue du Morvan, 54500 Vandœuvre-lès-Nancy
Maternité régionale :10 Avenue Dr Heydenreich, 54000 Nancy
- France
4
2LPN -
Laboratoire lorrain de psychologie et neurosciences de la dynamique des comportements
( 537313 )
- France
-
Université de Lorraine UR7489 ( 413289 )
5
DCAC -
Défaillance Cardiovasculaire Aiguë et Chronique
( 223006 )
- Faculté de Médecine - 9 avenue de la Forêt de Haye - BP 184 - 54500 Vandoeuvre les Nancy
- France
-
Centre Hospitalier Régional Universitaire de Nancy ( 300157 )
;
-
Institut National de la Santé et de la Recherche Médicale U1116 ( 303623 )
;
-
Université de Lorraine ( 413289 )
6
CIC -
Centre d'investigation clinique [Nancy]
( 254924 )
- 4 rue du Morvan - Bâtiment Louis Mathieu - 54500 Vandoeuvre-les-Nancy Cedex
- France
-
Centre Hospitalier Régional Universitaire de Nancy ( 300157 )
;
-
Institut National de la Santé et de la Recherche Médicale CIC1433 ( 303623 )
;
-
Université de Lorraine ( 413289 )
7
Service de Biochimie et Biologie Moléculaire, Nutrition et Métabolisme [CHRU Nancy]
( 505932 )
- 29 Avenue du Maréchal de Lattre de Tassigny 54035 Nancy.
- France
-
Centre Hospitalier Régional Universitaire de Nancy ( 300157 )
8
IADI -
Imagerie Adaptative Diagnostique et Interventionnelle
( 81479 )
- Université de Lorraine - CHU de Nancy, 4e étage, Tour Drouet, rue du Morvan, 54500 Vandoeuvre-les-Nancy
- France
-
Institut National de la Santé et de la Recherche Médicale UMRS947/UMRS1254 ( 303623 )
;
-
Université de Lorraine ( 413289 )
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Date de publication |
2019-07
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Langue du document |
Anglais
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Nom de la revue |
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Vulgarisation |
Non
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Comité de lecture |
Oui
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Audience |
Internationale
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Volume |
266
|
Numéro |
7
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Page/Identifiant |
1685-1692
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Domaine(s) |
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Sciences cognitives/Psychologie
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Sciences cognitives/Neurosciences
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Sciences de l'Homme et Société/Psychologie
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Sciences de l'Homme et Société/Education
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Sciences du Vivant [q-bio]/Neurosciences [q-bio.NC]/Psychologie et comportements
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Sciences du Vivant [q-bio]/Neurosciences [q-bio.NC]/Sciences cognitives
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Mots-clés |
en
Alzheimer's disease, CSF biomarkers, Aß42, amyloid PET, quantitative analysis
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DOI |
10.1007/s00415-019-09315-y |
Pubmed Id |
30963253 |