Liquormarker in der Diagnostik bei Patienten mit Morbus Parkinson, Parkinson-Demenz-Komplex und Morbus Alzheimer

Cerebrospinal fluid biomarkers in the diagnostic of Parkinson´s disease, Parkinson´s disease with dementia and Alzheimer´s disease

by Henning Lemke
Doctoral thesis
Date of Examination:2015-10-13
Date of issue:2015-09-24
Advisor:Prof. Dr. Inga Zerr
Referee:Prof. Dr. Inga Zerr
Referee:Prof. Dr. Martin Sommer
Referee:Prof. Dr. Christine Stadelmann-Nessler
Persistent Address: http://dx.doi.org/10.53846/goediss-5253

 

 

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Abstract

English

Suffering from dementia, such as Alzheimer’s disease ("AD") and Parkinson’s disease with dementia ("PDD"), has far-reaching consequences for the patient’s self-determined life. In contrast to Alzheimer’s disease, there’s a lack of validated cerebrospinal fluid biomarkers in Parkinson’s disease with and without dementia. This study analysed the cognitive performance (using the CERAD–trial) of patients with Parkinson’s disease with and without dementia and compared them with those from patients with Alzheimer’s disease. In a second step, well-known and new CSF-biomarkers for all of the three diseases were evaluated. We found out that the CERAD trial can be used for PDD-patients as it differentiates reliably between PDD and a cognitive healthy compare group. Moreover, we were able to show that patients with PDD have, in contrast to AD, a cognitive disorder with focus on frontal and executive functions. The well-known CSF-biomarkers Tau-Protein, Phospho-Tau and Amyloid-beta 1-42 are able to differentiate AD from PD and PDD, but cannot be used to diagnose PDD or PD, as both disorders showed normal concentrations of Tau-Protein, Phospho-Tau and Amyloid-beta 1-42 in their CSF. For Apolioprotein E ("ApoE"), we found significant lower CSF-concentrations in AD in contrast to PD, PDD and standard levels from other studies. Moreover, there was a correlation between lower CSF-concentration of ApoE and worse performance in psychomotoric speed and executive function. We conclude that ApoE might find a role as CSF-biomarker in Alzheimer’s disease.  The measurement of CSF-Homocysteine showed significant differences in the correlation of AD vs. PDD and of AD vs. PD. That’s why it gives reason to use the biomarker to distinguish between AD and PDD. It has to be concluded that a reliable differentiation between PD and PDD is not possible with any of the analysed biomarkers.
Keywords: cerebrospinal fluid; biomarker; Parkinson´s disease dementia; Alzheimer´s disease; CERAD; neuropsychological testing
 
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