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CSF total tau and tau protein phosphorylated at threonine 181 in the differential diagnosis of Alzheimer's disease and vascular cognitive impairment

Alzheimer's disease (AD) and vascular cognitive impairment (VCI) are the two most common causes of dementia in older age groups. Due to inadequacy of current clinical diagnostic criteria in differential diagnosis of dementia, the identification of new biomarkers that would help establishing the diagnosis and primary cause of the dementia is therefore of great relevance. The aim of this study was to investigate the diagnostic accuracy of two potential CSF biomarkers, total tau protein (t-tau) and tau protein phosphorylated at threonine 181 (p-tau181) in the differential diagnosis of patients with AD and VCI. The concentrations of CSF biomarkers were measured in 29 AD patients, 12 VCI patients and 25 control subjects. The CSF concentrations of both markers were significantly higher in AD group compared to VCI (p>0.001) group and control subjects (p<0.001) ; however none fulfilled the criteria for the "ideal" marker (sensitivity and specificity higher than 85%). Finally, using logistic regression analysis with t-tau and p-tau181 as independent variables led to improvement in diagnostic accuracy with correct classification in more than 85% of cases.

Cerebrospinal fluid; dementia; Alzheimer's disease; vascular cognitive impairment

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