Two-level diagnostic classification using cerebrospinal fluid YKL-40 in Alzheimer's disease.

Abstract

INTRODUCTION:

We assessed the diagnostic accuracy of cerebrospinal fluid (CSF) YKL-40 in discriminating (1) clinical Alzheimer's disease (AD) from cognitively healthy controls (HCs) and frontotemporal dementia (FTD) (level I) and (2) patients stratified by different pathophysiological profiles from HCs and FTD following a novel unbiased/descriptive categorization based on CSF biomarkers, independent of cognitive impairment severity (level II).

METHODS:

YKL-40 was compared among HCs (n = 21), mild cognitive impairment (n = 41), AD (n = 35), and FTD (n = 9) (level I) and among HCs (n = 21), AD pathophysiology (tau and amyloid β) negative (n = 15), tau positive (n = 15), amyloid β positive (n = 13), AD pathophysiology positive (n = 33), and FTD (n = 9) (level II).

RESULTS:

Level I: YKL-40 discriminated AD from HC and FTD (area under the receiver operating characteristic curves [AUROCs] = 0.69, 0.71). Level II: YKL-40 discriminated tau-positive individuals and AD pathophysiology-positive individuals from HC, AD pathophysiology-positive patients from FTD (AUROCs = 0.76, 0.72, 0.73).

DISCUSSION:

YKL-40 demonstrates fair performance in distinguishing tau-positive patients from HCs, suggesting it may aid clinical diagnosis and support a biomarker-guided pathophysiological stratification.

• Authors: Filippo Baldacci, Nicola Toschi, Simone Lista, Henrik Zetterberg, Kaj Blennow, Ingo Kilimann, Stefan Teipel, Enrica Cavedo, Antonio Melo Dos Santos, Stéphane Epelbaum, Foudil Lamari, Bruno Dubois, Roberto Floris, Francesco Garaci, Ubaldo Bonuccelli, Harald Hampel
• Journal: Alzheimer's & dementia : the journal of the Alzheimer's Association (Alzheimers Dement) Vol. 13 Issue 9 Pg. 993-1003 (Sep 2017) ISSN: 1552-5279 [Electronic] United States
• PMID: 28263742 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• CHI3L1 protein, human
• Chitinase-3-Like Protein 1

Topics

• Aged
• Alzheimer Disease (cerebrospinal fluid, diagnosis)
• Biomarkers (cerebrospinal fluid)
• Chitinase-3-Like Protein 1 (cerebrospinal fluid)
• Cognitive Dysfunction (cerebrospinal fluid, diagnosis)
• Cross-Sectional Studies
• Female
• Frontotemporal Dementia (cerebrospinal fluid)
• Humans
• Male
• Middle Aged
• ROC Curve
• Retrospective Studies