Tau-Protein-Spiegel in der Diagnostik der Alzheimer-Demenz

P. Schönknecht; J. Pantel; E. Werle; T. Hartmann; M. Essig; K. Baudendistel; K. Beyreuther; J. Schröder

doi:10.1055/s-2000-7732

Fortschritte der Neurologie · Psychiatrie, Inhaltsverzeichnis

Fortschr Neurol Psychiatr 2000; 68(10): 439-446
DOI: 10.1055/s-2000-7732

ORIGINALARBEIT

Georg Thieme Verlag Stuttgart · New York

Tau-Protein-Spiegel in der Diagnostik der Alzheimer-Demenz

P. Schönknecht¹ , J. Pantel¹ , E. Werle² , T. Hartmann³ , M. Essig⁴ , K. Baudendistel⁴ , K. Beyreuther³ , J. Schröder¹

¹Sektion Gerontopsychiatrie, Psychiatrische Klinik der Universität Heidelberg;
²Zentrallabor der Medizinischen Klinik der Universität Heidelberg;
³Zentrum für Molekulare Biologie Heidelberg (ZMBH);
⁴Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologische Diagnostik und Therapie, Heidelberg

Abstract

Zusammenfassung:

Die Konzentration des Tau-Proteins im Liquor zerebrospinalis wurde bei 55 Patienten mit Alzheimer-Demenz (AD), 18 Patienten mit vaskulärer Demenz (VD), 19 Patienten mit Demenzen anderer Ursache und 14 altersangeglichenen depressiv Erkrankten bestimmt. Im Gruppenvergleich bestanden bei den AD-Patienten signifikant (p < 0,05) erhöhte Tau-Spiegel (564,5 ± 275,5 pg/ml) gegenüber allen anderen Untersuchungsgruppen (VD: 406,5 ± 263,9 pg/ml; andere Demenzformen: 275,0 ± 135,4 pg/ml; depressiv Erkrankte: 212,9 ± 115,6 pg/ml). Allerdings zeigten die Tau-Spiegel innerhalb der AD-Gruppe eine hohe Spannweite (163,2 pg/ml - 1200 pg/ml); bei AD-Patienten mit niedrigen Werten unterhalb der 25 %-Quartile - darunter ein hoher Anteil von Patienten mit präsenilem Beginn - waren ähnliche Tau-Spiegel wie bei den nicht demenziell beeinträchtigten depressiv Erkrankten nachweisbar. Signifikante Korrelationen zwischen der Tau-Konzentration und klinischen Variablen wie Lebensalter, Ersterkrankungsalter, Krankheitsdauer, Schweregrad der demenziellen Symptomatik und magnetresonanztomographisch bestimmten hirnvolumetrischen Veränderungen bestanden innerhalb der AD-Patientengruppe nicht. Weder ein Einfluss des Apo-E-Genotyps noch einer eventuellen psychotropen Medikation auf die Tau-Spiegel konnte bei den AD-Patienten festgestellt werden. Übereinstimmend mit anderen Autoren bestätigen unsere Ergebnisse erhöhte Tau-Spiegel bei der AD. Im Gruppenvergleich gilt dieser Befund auch gegenüber der VD und anderen Demenzformen. Allerdings sind erhöhte Tau-Spiegel bei einem Teil der AD-Patienten nicht nachweisbar; ein Befund, der in weiteren Studien abzuklären ist.

Cerebrospinal Fluid Protein Tau Levels in the Differential Diagnosis of Alzheimer's Disease:

Tau protein concentration in cerebrospinal fluid was determined in 55 patients with Alzheimer's disease (AD), 18 patients with vascular dementia (VD), 19 patients with dementia caused by other disorders and 14 patients with major depression. Significantly (p < 0.05) elevated protein tau concentrations were found in AD patients (564.5 ± 275.5 pg/ml) compared to all other patient groups (VD: 406.5 ± 263.9 pg/ml; other dementia: 275.0 ± 135.4 pg/ml; depression: 212.9 ± 115.6 pg/ml). However, tau levels in AD patients covered a broad range (163.2 pg/ml - 1200 pg/ml). AD patients with tau levels below the 25 %-percentile of the distribution (among them a high percentage of patients with presenile onset) showed tau levels similar to those of the patients with late life depression. No significant correlations between tau levels and clinical variables such as severity of dementia, age, age of onset, duration of illness, and cerebral changes as assessed by volumetric magnetic resonance imaging could be demonstrated. Similarly, we could not find an influence of either APO-E genotype or psychotropic medication on the tau levels in AD patients. In accordance with other studies our results confirm elevated tau levels in AD compared to elderly not demented control subjects. Comparing groups, this finding applies as well with respect to VD and other dementing disorders. However, elevated tau levels cannot be detected in a subgroup of AD patients. This finding needs to be further investigated in future studies.

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Referenzen

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Dr Peter Schönknecht

Psychiatrische Klinik der Universität Heidelberg

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