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An efficient combination of quadruple biomarkers in binary classification using ensemble machine learning technique for early onset of Alzheimer disease. Neural Comput Appl 2022. [DOI: 10.1007/s00521-022-07076-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Abstract
Laboratory-specific reference values for cerebrospinal fluid (CSF) Alzheimer disease (AD) biomarkers are necessary. Our objective was to apply well-known CSF biomarkers and redetermine their diagnostic cutoff values for AD in South Korea. CSF samples from matched control subjects (n=71), patients with AD dementia (ADD, n=76), and other neurological disorders with cognitive decline (OND, n=47) were obtained from 6 Korean dementia clinics according to a standardized protocol. CSF biomarker concentrations were measured using enzyme-linked immunosorbent assay. CSF biomarkers differed significantly between the ADD and control groups (P<0.001 for all), and between the ADD and OND groups (P<0.001 for all). The areas under the curve in differentiation of ADD from control subjects were 0.97 for Aβ42, 0.93 for total tau (tTau), 0.86 for pTau, and 0.99 for both tTau/Aβ42 and pTau/Aβ42 ratios. Our revised cutoff value for Aβ42 was higher than our previous one, whereas the values for the Tau proteins were similar. The tTau/Aβ42 ratio had the highest accuracy, 97%. Our findings highlight the usefulness of CSF AD biomarkers in South Korea, and the necessity of continually testing the reliability of cutoff values.
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Zhang XY, Yang ZL, Lu GM, Yang GF, Zhang LJ. PET/MR Imaging: New Frontier in Alzheimer's Disease and Other Dementias. Front Mol Neurosci 2017; 10:343. [PMID: 29163024 PMCID: PMC5672108 DOI: 10.3389/fnmol.2017.00343] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/10/2017] [Indexed: 12/31/2022] Open
Abstract
Alzheimer's disease (AD) is the most common form of dementia; a progressive neurodegenerative disease that currently lacks an effective treatment option. Early and accurate diagnosis, in addition to quick elimination of differential diagnosis, allows us to provide timely treatments that delay the progression of AD. Imaging plays an important role for the early diagnosis of AD. The newly emerging PET/MR imaging strategies integrate the advantages of PET and MR to diagnose and monitor AD. This review introduces the development of PET/MR imaging systems, technical considerations of PET/MR imaging, special considerations of PET/MR in AD, and the system's potential clinical applications and future perspectives in AD.
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Affiliation(s)
- Xin Y Zhang
- Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhen L Yang
- Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guang M Lu
- Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Gui F Yang
- Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Long J Zhang
- Medical Imaging Center, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Wang MJ, Yi S, Han JY, Park SY, Jang JW, Chun IK, Giau VV, Bagyinszky E, Lim KT, Kang SM, An SSA, Park YH, Youn YC, Kim S. Analysis of Cerebrospinal Fluid and [11C]PIB PET Biomarkers for Alzheimer's Disease with Updated Protocols. J Alzheimers Dis 2017; 52:1403-13. [PMID: 27163824 DOI: 10.3233/jad-160143] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Recently, a Korean research group suggested a consensus protocol, based on the Alzheimer's Disease Neuroimaging Initiative study protocol but with modifications for minimizing the confounding factors, for the evaluation of cerebrospinal fluid (CSF) biomarkers. OBJECTIVE Here, we analyzed fluid and imaging biomarkers of Alzheimer's disease (AD) in Korean population. We used the updated protocol to propose a more accurate CSF biomarker value for the diagnosis of AD. METHODS Twenty-seven patients with AD and 30 cognitively normal controls (NC) were enrolled. CSF was collected from 55 subjects (patients with AD = 26, NC = 29) following the Korea consensus protocol. CSF biomarkers were measured using the INNO-BIA AlzBio3 immunoassay, and Pittsburgh compound B (PIB) positron emission tomography (PET) scans were also performed. RESULTS The cutoff values of CSF amyloid beta 1-42 (Aβ42), total tau (t-Tau), and phosphorylated tau (p-Tau) proteins were 357.1 pg/ml, 83.35 pg/ml, and 38.00 pg/ml, respectively. The cutoff values of CSF t-Tau/Aβ42 and p-Tau/Aβ42 ratio- were 0.210 (sensitivity 100%, specificity 86.21%) and 0.1350 (sensitivity 88.46%, specificity of 92.86%). The concordance rate with PIB-PET was higher using the CSF t-Tau/Aβ42 ratio (κ= 0.849, CI 0.71-0.99) than CSF Aβ42 alone (κ= 0.703, CI 0.51-0.89). CONCLUSIONS Here, we improved controversial factors associated with the previous CSF study protocol and suggested a new cutoff value for the diagnosis of AD. Our results showed good diagnostic performance for differentiation of AD. Thus, we expect our findings could be a cornerstone in the establishment and clinical application of biomarkers for AD diagnosis.
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Affiliation(s)
- Min Jeong Wang
- Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - SangHak Yi
- Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - Jee-Young Han
- Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - So Young Park
- Department of Neurology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Chuncheon-si, Republic of Korea
| | - In Kook Chun
- Department of Nuclear Medicine, School of Medicine, Kangwon National University, Chuncheon-si, Gangwon-do, Republic of Korea
| | - Vo Van Giau
- Department of Bionano Technology, Gachon Medical Research Institute, Gachon University, Seongnam-si, Republic of Korea
| | - Eva Bagyinszky
- Department of Bionano Technology, Gachon Medical Research Institute, Gachon University, Seongnam-si, Republic of Korea
| | | | | | - Seong Soo A An
- Department of Bionano Technology, Gachon Medical Research Institute, Gachon University, Seongnam-si, Republic of Korea
| | - Young Ho Park
- Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Republic of Korea
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Kim HJ, Park KW, Kim TE, Im JY, Shin HS, Kim S, Lee DH, Ye BS, Kim JH, Kim EJ, Park KH, Han HJ, Jeong JH, Choi SH, Park SA. Elevation of the Plasma Aβ40/Aβ42 Ratio as a Diagnostic Marker of Sporadic Early-Onset Alzheimer's Disease. J Alzheimers Dis 2016; 48:1043-50. [PMID: 26444752 DOI: 10.3233/jad-143018] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although plasma amyloid-β (Aβ) levels have been evaluated as a possible diagnostic marker of Alzheimer's disease (AD), the findings are inconsistent. OBJECTIVE The present study aimed to validate plasma levels of Aβ40, Aβ42, and the Aβ40/Aβ42 ratio as biomarkers of AD in subjects with early-onset AD (EOAD) without familial AD genetic mutations. METHODS Patients with sporadic EOAD (sEOAD) were prospectively recruited by nine neurology clinics. Plasma levels of Aβ40 and Aβ42 were measured using a sandwich enzyme-linked immunosorbent assay (ELISA) in 100 sEOAD (50-69 year-old) and 46 age-matched normal control subjects (50-72 year-old). Cerebrospinal fluid (CSF) was obtained from 32 sEOAD subjects and 25 controls. The integrity of the blood-brain barrier was assessed using the CSF/plasma albumin ratio. RESULTS The plasma levels of Aβ42 were significantly lower, while the Aβ40/Aβ42 ratio was significantly higher in sEOAD patients than in controls. The levels of Aβ40, Aβ42, and the Aβ40/Aβ42 ratio did not differ in relation to the APOEɛ4 allele. The CSF/plasma albumin ratio was comparable between the two groups, and the plasma parameters of Aβ proteins were not significantly associated. A multivariate analysis revealed that an increased Aβ40/Aβ42 ratio is valuable for the discrimination of sEOAD from controls (β=0.344, p=0.000). The area under the ROC curve for the Aβ40/Aβ42 ratio was 0.76, and a cut-off ratio of 5.87 was suggested to have 70% sensitivity and 68% specificity. CONCLUSION The plasma Aβ40/Aβ42 ratio had moderate validity for the discrimination of sEOAD patients from age-matched controls.
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Affiliation(s)
- Hyeong Jun Kim
- Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A University College of Medicine, Dong-A University Hospital, Busan, Korea
| | - Tae Eun Kim
- Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Ji Young Im
- Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Ho Sik Shin
- Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Saeromi Kim
- Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Dong Hyun Lee
- Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hun Kim
- Department of Neurology, Ilsan Hospital, National Health Insurance Corporation, Goyang, Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Busan, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University, College of Medicine, Incheon, Korea
| | - Hyun Jeong Han
- Department of Neurology, Myongii Hospital, Seonam University College of Medicine, Goyang, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Sun Ah Park
- Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Park SA, Kang JH, Kang ES, Ki CS, Roh JH, Youn YC, Kim SY, Kim SY. A consensus in Korea regarding a protocol to reduce preanalytical sources of variability in the measurement of the cerebrospinal fluid biomarkers of Alzheimer's disease. J Clin Neurol 2015; 11:132-41. [PMID: 25851891 PMCID: PMC4387478 DOI: 10.3988/jcn.2015.11.2.132] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 11/17/2022] Open
Abstract
Cerebrospinal fluid (CSF) can provide vital informative about pathological processes occurring in the brain. In particular, the CSF concentrations of Aβ42, tTau, and pTau181 are useful for the early diagnosis of Alzheimer's disease (AD). However, many studies have demonstrated that confounding factors related to the preanalytical processing of CSF can seriously influence measurements of these AD biomarkers. It is therefore important to develop a standardized protocol for the acquisition and handling of CSF, particularly with regard to the types of tube used for collection and storage, the proper aliquot volume, blood contamination, and the number of tube transfers and freeze-thaw cycles, because these aspects of the procedure have been shown to affect AD biomarker measurements. A survey of the impact of several individual preanalytical procedures on the measurement of AD biomarkers in CSF was conducted for this review article, and the implications of the differences among them are discussed. Furthermore, following a review of the procedures used in Korean and international biomarker laboratories, a consensus was reached among a cooperative Korean multicenter research group regarding a standardized protocol for the analysis of AD biomarkers in CSF. All efforts were made to be stringent regarding the controversial issues associated with this protocol, thus minimizing the confounding influence of various factors on current investigations using established AD biomarkers and on future studies using novel biomarkers of AD and other neurodegenerative disorders.
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Affiliation(s)
- Sun Ah Park
- Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
| | - Ju Hee Kang
- Department of Pharmacology & Clinical Pharmacology, Inha University School of Medicine, Incheon, Korea.; Department of Pathology & Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eun Suk Kang
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang Seok Ki
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jee Hoon Roh
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Chul Youn
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong Yoon Kim
- Department of Neurology, Chung-Ang University Hospital, Seoul, Korea
| | - Sang Yun Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
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Atypical Early-Onset Alzheimer's Disease Dementia Diagnosed by Biomarker Study. Dement Neurocogn Disord 2015. [DOI: 10.12779/dnd.2015.14.4.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Efficacy of the Phosphorylated tau 181 in Differential Diagnosis of the Alzheimer's Disease: A Systematic Review and Meta-Analysis. Dement Neurocogn Disord 2014. [DOI: 10.12779/dnd.2014.13.4.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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