Thesis defense Petra Spies (Donders Series 79)
March 15, 2012.
Promotor: Prof.dr. M.G.M. Olde Rikkert, copromotors: dr. ir. M.M. Verbeek, dr. J.A.H.R. Claassen
The reflection of Alzheimer disease in CSF
It is not easy to distinguish dementia due to Alzheimer disease (AD) from other types of dementia, despite the existence of criteria sets that specify the features of each type of dementia. Patients presenting themselves at a memory clinic often show features that may be compatible with more than one of type of dementia. Cerebrospinal fluid (CSF) biomarkers – concentrations of certain proteins in the fluid that surrounds the brain – are considered to reflect the dementia-specific pathophysiological process in the brain and may thus be useful in diagnosing dementia.
The diagnostic value of these CSF biomarkers was investigated in this thesis. It was found that two of them, the concentrations of amyloid β42 and phosphorylated tau, can be used to accurately predict the probability that a memory clinic patient suspected of dementia has AD. However, when CSF biomarkers were used to test several hypotheses on the aetiology of AD, it became clear that the CSF biomarkers are not a straightforward reflection of the situation in the brain. The discrepancy between said aetiological hypotheses on AD and the CSF biomarker results underlines that much is still unknown about the pathophysiology of AD. However, better understanding of the (mis)metabolism of these CSF biomarkers may provide the key to unravel AD pathophysiology.