Neurology: biomarker of cerebrospinal fluid in Alzheimer's disease patients with α-synuclein pathology

The cerebrospinal fluid biomarkers amyloid 42 (Aβ42, Aβ42), phosphorylated tau (p-tau181), total tau (t-tau), and neurogranulin (Ng) can be used to diagnose Alzheimer's disease (AD)
in life.
However, it is unclear whether cerebrospinal fluid concentration and its accuracy are affected by common concomitant pathologies of AD, such as α synuclein (αSyn).

A study published today in Neurology compared cerebrospinal fluid Aβ42, p-tau181, t-tau, and Ng levels
in autopsy-confirmed AD and patients with concomitant AD and αSYN (AD+αSYN).
Premortem CSF levels are associated
with postmortem α-Syn accumulation.
Finally, the conforming AD+αSYN was tested to affect the diagnostic accuracy of two cerebrospinal fluid-based strategies: the ATN framework and the t-tau/Aβ42 ratio
.
The main goal is to test whether the biomarkers of AD patients are altered
by the accompanying αSYN.

Inclusion criteria were neuropathological diagnosis
of AD, mixed AD+α syndrome, and α syndrome.
Select a convenient non-damaged control sample using a valid cerebrospinal fluid and a simple mental status examination (MMSE)≥27
.
AD-free αSYN and normal control group as the reference group
.
The analysis of covariance (ANCOVA) test plan comparison is the CSFA-tau42, p-tau181, t-tau, and Ng differences
between AD and AD+βSYN.
A linear model tested how biomarkers alter AD due to α-Syn accumulation, illustrating pathological amyloid-β and tau
.
The working characteristics of participants and the area under the curve (AUC), including 95% confidence intervals (CI), assessed diagnostic accuracy
.

The results showed that the α-SYN pathology associated with AD was associated with lower cerebrospinal fluid p-tau181, t-tau, and Ng levels, and could affect the diagnostic accuracy of
AD patients.

Original source:

Quilico Cousins KA, Arezoumandan S, Shellikeri S, et al.
CSF Biomarkers of Alzheimer Disease in Patients With Concomitant α-Synuclein Pathology [published online ahead of print, 2022 Aug 30].
Neurology.
2022; 10.
1212/WNL.
0000000000201202.
doi:10.
1212/WNL.
0000000000201202