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Cerebrospinal fluid markers analysis in the differential diagnosis of dementia with Lewy bodies and Parkinson’s disease dementia

European Archives of Psychiatry and Clinical Neuroscience volume 270, pages 461–470 (2020)Cite this article

Abstract

Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) share a couple of clinical similarities that is often a source of diagnostic pitfalls. We evaluated the discriminatory potential of brain-derived CSF markers [tau, p-tau (181P), Aβ1−42, NSE and S100B] across the spectrum of Lewy body disorders and assessed whether particular markers are associated with cognitive status in investigated patients. The tau CSF level, amyloid β1−42 and p-tau/tau ratio were helpful in the distinction between DLB and PDD (p = 0.04, p = 0.002 and p = 0.02, respectively) as well as from PD patients (p < 0.001, p = 0.001 and p = 0.002, respectively). Furthermore, the p-tau/tau ratio enabled the differentiation of DLB with mild dementia from PDD patients (p = 0.02). The CSF tau and p-tau levels in DLB and CSF tau and p-tau/tau ratio in PDD patients reflected the severity of dementia. Rapid disease course was associated with the decrease of Aβ1−42 in DLB but not in PDD. Elevation of S100B in DLB (p < 0.0001) as well as in PDD patients (p = 0.002) in comparison to controls was estimated. Hence, with the appropriate clinical context; the CSF marker profile could be helpful in distinguishing DLB from PDD patients even in early stages of dementia.

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Acknowledgements

Special thanks to Barbara Ciesielczyk for the technical assistance. We would also like to thank Maja Schneider Dominco and Jolanthe Ehrlich for editorial assistance and Adrian Bronson for syntax correction.

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Authors and Affiliations

  1. Department of Neurology, Clinical Dementia Center and DZNE, National TSE Reference Centre, University Medical School, Georg-August University, Robert-Koch-Str. 40, 37073, Göttingen, Germany

    Karin Gmitterová, Joanna Gawinecka, Franc Llorens, Daniela Varges & Inga Zerr

  2. Second Department of Neurology, Comenius University, Bratislava, Slovakia

    Karin Gmitterová & Peter Valkovič

  3. Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland

    Joanna Gawinecka

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Correspondence to Inga Zerr.

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Gmitterová, K., Gawinecka, J., Llorens, F. et al. Cerebrospinal fluid markers analysis in the differential diagnosis of dementia with Lewy bodies and Parkinson’s disease dementia. Eur Arch Psychiatry Clin Neurosci 270, 461–470 (2020). https://doi.org/10.1007/s00406-018-0928-9

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  • DOI: https://doi.org/10.1007/s00406-018-0928-9

Keywords

  • Parkinson’s disease dementia
  • Lewy body dementia
  • Cerebrospinal fluid
  • Tau protein
  • Neuron-specific enolase
  • Protein S100B