Wiltfang J, Lewczuk P
Centro de Neuroproteômica Clínica, Erlangen, Alemanha
Riederer P, Grünblatt E
Clínica de Psiquiatria e Psicoterapia, Departamento de Neuroquímica Clínica, Bayerische Julius-Maximilians-University Würzburg, Würzburg, Alemanha.
Hock C
Divisão de Pesquisa em Psiquiatria, Universidade de Zurique, Zurique, Suíça.
Scheltens P
Centro de Alzheimer/Departamento de Neurologia, Centro Médico da Universidade VU, Amsterdã, Holanda
Hampel H
Departamento de Psiquiatria, Universidade Ludwig Maximilian, Munique, Alemanha
Vanderstichele H
Innogenetics, Ghent, Bélgica
Iqbal K
Departamento de Neuroquímica, Departamento de Neuropatologia Clínica, Instituto do Estado de Nova Iorque para Pesquisas Básicas em Incapacidades do Desenvolvimento, Nova Iorque, NY, EUA.
Galasko D
Departamento de Neurociências UCSD, La Jolla, CA, EUA.
Lannfelt L
Departamento de Saúde Pública e de Ciências do Atendimento à Saúde/Geriatria, Universidade Uppsala, Uppsala, Suécia.
Otto M
Departamento de Neurologia, Universidade de Goettingen, Goettingen, Alemanha.
Esselman H
Departamento de Psiquiatria e Psicoterapia, Universidade de Goettingen, Goettingen, Alemanha.
Henkel AW
Departamento de Psiquiatria e Psicoterapia, Universidade de Erlangen-Nuremberg, Erlangen, Alemanha.
Kornhuber J
Departamento de Psiquiatria e Psicoterapia, Universidade de Goettingen, Goettingen, Alemanha.
Blennow K
Departamento de Neurociências Clínicas, Seção de Neurociência Experimental, Hospital da Universidade Sahlgrenska, Mölndal, Suécia
Abstract:
Aging of population, and increasing life expectancy result in an increasing number of patients with dementia. This symptom can be a part of a completely curable disease of the central nervous system (e.g, neuroinflammation), or a disease currently considered irreversible (e.g, Alzheimer’s disease, AD). In the latter case, several potentially successful treatment approaches are being tested now, demanding reasonable standards of pre-mortem diagnosis. Cerebrospinal fluid and serum analysis (CSF/serum analysis), whereas routinely performed in neuroinflammatory diseases, still requires standardization to be used as an aid to the clinically based diagnosis of AD. Several AD-related CSF parameters (total tau, phosphorylated forms of tau, Aß peptides, ApoE genotype, p97, etc.) tested separately or in a combination provide sensitivity and specificity in the range of 85%, the figure commonly expected from a good diagnostic tool. In this review, recently published reports regarding progress in neurochemical pre-mortem diagnosis of dementias are discussed with a focus on an early and differential diagnosis of AD. Novel perspectives offered by recently introduced technologies, e.g, fluorescence correlation spectroscopy (FCS) and surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) are briefly discussed.
Keywords:Dementia, Alzheimer’s disease, neuroinflammation, cerebrospinal fluid.