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Home > Differential Diagnosis of Dementia with High Levels of Cerebrospinal Fluid Tau Protein.

TitleDifferential Diagnosis of Dementia with High Levels of Cerebrospinal Fluid Tau Protein.
Publication TypeJournal Article
Year of Publication2016
AuthorsGrangeon, L, Paquet, C, Bombois, S, Quillard-Muraine, M, Martinaud, O, Bourre, B, Lefaucheur, R, Nicolas, G, Dumurgier, J, Gerardin, E, Jan, M, Laplanche, J-L, Peoc'h, K, Hugon, J, Pasquier, F, Maltête, D, Hannequin, D, Wallon, D
Corporate Authorscollaborators of the ePLM.fr group
JournalJ Alzheimers Dis
Volume51
Issue3
Pagination905-13
Date Published2016
ISSN1875-8908
KeywordsAdult, Age of Onset, Aged, Aged, 80 and over, Alzheimer Disease, Biomarkers, Creutzfeldt-Jakob Syndrome, Dementia, Vascular, Diagnosis, Differential, Female, France, Frontotemporal Dementia, Humans, Lewy Body Disease, Male, Mental Status Schedule, Middle Aged, Phosphorylation, Retrospective Studies, Sex Factors, tau Proteins
Abstract

BACKGROUND: Total Tau concentration in cerebrospinal fluid (CSF) is widely used as a biomarker in the diagnosis of neurodegenerative process primarily in Alzheimer's disease (AD). A particularly high Tau level may indicate AD but may also be associated with Creutzfeldt-Jakob disease (CJD). In such situations little is known about the distribution of differential diagnoses.

OBJECTIVE: Our study aimed to describe the different diagnoses encountered in clinical practice for patients with dementia and CSF Tau levels over 1000 pg/ml. We studied the p-Tau/Tau ratio to specify its ability to distinguish AD from CJD.

METHODS: Patients (n = 202) with CSF Tau levels over 1000 pg/ml were recruited in three memory clinics in France. All diagnoses were made using the same diagnostic procedure and criteria.

RESULTS: Patients were diagnosed with AD (n = 148, 73.2%), mixed dementia (n = 38, 18.8%), CJD, vascular dementia (n = 4, 2.0% for each), Lewy body dementia, and frontotemporal dementia (n = 3, 1.5% for each). Dispersion of CSF Tau levels clearly showed an overlap between all diagnoses. Using the p-Tau/Tau ratio suggestive of CJD (

CONCLUSION: Our study showed that in clinical practice, extremely high CSF Tau levels are mainly related to diagnosis of AD. CJD patients represent a minority. Our results support a sequential interpretation algorithm for CSF biomarkers in dementia. High CSF Tau levels should alert clinicians to check the p-Tau/Tau ratio to consider a probable diagnosis of CJD.

DOI10.3233/JAD-151111
Alternate JournalJ. Alzheimers Dis.
PubMed ID26890785
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Source URL: https://www.j-alz.com/content/differential-diagnosis-dementia-high-levels-cerebrospinal-fluid-tau-protein