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Abstract:

Objectives Cortical posterior hypometabolism on PET imaging with 18F - FDG ( FDG - PET ) , and altered levels of Aß1 - 42 peptide , total Tau ( tTau ) and phosphorylated Tau ( pTau ) proteins in cerebrospinal fluid ( CSF ) are established diagnostic biomarkers in Alzheimer's disease ( AD ) . An evaluation has been made of the concordance and relationship between the results of FDG - PET and CSF biomarkers in symptomatic patients with suspected AD . Material and methods A retrospective review was carried out on 120 patients with cognitive impairment referred to our Cognitive Neurology Unit , and who were evaluated by brain FDG - PET and a lumbar puncture for CSF biomarkers . In order to calculate their Kappa coefficient of concordance , the result of the FDG - PET and the set of the three CSF biomarkers in each patient was classified as normal , inconclusive , or AD - compatible . The relationship between the results of both methods was further assessed using logistic regression analysis , including the Aß1 - 42 , tTau and pTau levels as quantitative predictors , and the FDG - PET result as the dependent variable . Results The weighted Kappa coefficient between FDG - PET and CSF biomarkers was 0 .46 ( 95% CI : 0 .35 - 0 .57 ) . Logistic regression analysis showed that the Aß1 - 42 and tTau values together were capable of discriminating an FDG - PET result metabolically suggestive of AD from one non - suggestive of AD , with a 91% sensitivity and 93% specificity at the cut - off line Aß1 - 42=44+1 .3×tTau . Conclusions The level of concordance between FDG - PET and CSF biomarkers was moderate , indicating their complementary value in diagnosing AD . The Aß1 - 42 and tTau levels in CSF help to predict the patient FDG - PET cortical metabolic status .
cognitive impairment