From Cerebrospinal Fluid Neurochemistry to Clinical Diagnosis of Alzheimer’s Disease in the Era of Anti-Amyloid Treatments. Report of Four Patients
Ioanna Tsantzali,
Fotini Boufidou,
Eleni Sideri,
Antonis Mavromatos,
Myrto G. Papaioannou,
Aikaterini Foska,
Ioannis Tollos,
Sotirios G. Paraskevas,
Anastasios Bonakis,
Konstantinos I. Voumvourakis,
Georgios Tsivgoulis,
Elisabeth Kapaki,
George P. Paraskevas
Affiliations
Ioanna Tsantzali
2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Fotini Boufidou
Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Eginition” Hospital, 11528 Athens, Greece
Eleni Sideri
2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Antonis Mavromatos
2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Myrto G. Papaioannou
Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Eginition” Hospital, 11528 Athens, Greece
Aikaterini Foska
2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Ioannis Tollos
2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Sotirios G. Paraskevas
Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Eginition” Hospital, 11528 Athens, Greece
Anastasios Bonakis
2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Konstantinos I. Voumvourakis
2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Georgios Tsivgoulis
2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Elisabeth Kapaki
Neurochemistry and Biological Markers Unit, 1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Eginition” Hospital, 11528 Athens, Greece
George P. Paraskevas
2nd Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Analysis of classical cerebrospinal fluid biomarkers, especially when incorporated in a classification/diagnostic system such as the AT(N), may offer a significant diagnostic tool allowing correct identification of Alzheimer’s disease during life. We describe four patients with more or less atypical or mixed clinical presentation, in which the classical cerebrospinal fluid biomarkers amyloid peptide with 42 and 40 amino acids (Aβ42 and Aβ40, respectively), phospho-tau (τP-181) and total tau (τΤ) were measured. Despite the unusual clinical presentation, the biomarker profile was compatible with Alzheimer’s disease in all four patients. The measurement of classical biomarkers in the cerebrospinal fluid may be a useful tool in identifying the biochemical fingerprints of Alzheimer’s disease, especially currently, due to the recent approval of the first disease-modifying treatment, allowing not only typical but also atypical cases to be enrolled in trials of such treatments.
