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The cognitive profile and CSF biomarkers in dementia with Lewy bodies and Parkinson's disease dementia

Authors

  • M. Andersson,

    1. Neuropsychiatric clinic, Malmö University Hospital, Malmö, Sweden
    2. Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden
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  • H. Zetterberg,

    1. Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
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  • L. Minthon,

    1. Neuropsychiatric clinic, Malmö University Hospital, Malmö, Sweden
    2. Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden
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  • K. Blennow,

    1. Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
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  • E. Londos

    Corresponding author
    1. Neuropsychiatric clinic, Malmö University Hospital, Malmö, Sweden
    • Neuropsychiatric clinic, Malmö University Hospital, Malmö Sweden.
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Abstract

Objective

Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) may be viewed as different points on a continuum reflecting the regional burden and distribution of pathology. An important clinical consideration is overlapping Alzheimer's disease (AD) pathology, since it has been reported that associated AD pathology in DLB shortens survival and leads to a more rapid cognitive decline. We aimed to investigate cerebrospinal fluid (CSF) biomarkers and the associated cognitive profile in DLB and PDD.

Methods

Clinically diagnosed DLB (n = 47) and PDD (n = 17) patients from a clinical follow-up programme were investigated. All performed mini mental state examination (MMSE) and went through lumbar puncture at baseline. CSF concentrations of total τ (T-τ), τ phosphorylated at threonine 181 (P-τ181) and the 42 amino acid isoform of amyloid β, Aβ42 were determined.

Results

We found significant differences in T-τ and Aβ42, with a higher level of T-τ and a lower level of Aβ42 in DLB compared to PDD. The combination of T-τ with Aβ42 showed better discrimination between DLB and PDD than either of the measures alone. In DLB, a CSF profile more like the one seen in AD was significantly correlated with worse performance on the orientation and memory of the MMSE.

Conclusion

The correlation suggests a possible link between a higher degree of AD pathology and a profile of more temporal disabilities on cognitive tests in DLB. This might aid in identifying a subgroup of patients with a greater burden of AD pathology in a clinical setting and could have important implications for prognosis. Copyright © 2010 John Wiley & Sons, Ltd.

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