Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Research Article Dement Geriatr Cogn Disord 2010;29:530–533 DOI: 10.1159/000314679 CSF-Tau and CSF-A  1–42 in Posterior Cortical Atrophy Thomas P. Baumann   a, b Hüseyin Duyar   b Marc Sollberger   a, b Jens Kuhle   b Axel Regeniter   c Baltazar Gomez-Mancilla   d Klaus Schmidtke   e Andreas U. Monsch   a a  Memory Clinic – Neuropsychology Center, Departments of Geriatrics, b  Department of Neurology, and c  CSF Laboratory, University Hospital, and d  Neurosciences, NS Discovery, Novartis Pharma AG, Basel, Switzerland; e  Center for Geriatric Medicine and Gerontology, University Hospital Freiburg, Freiburg, Germany Posterior cortical atrophy (PCA) is an uncommon ear- ly-onset dementia characterized by progressive visuospa- tial dysfunction [1–3]. Elements of Balint’s syndrome, Gerstmann’s syndrome, visual agnosia and topographi- cal disorientation are typical manifestations of PCA. Memory and insight remain relatively intact. Alzheimer’s amyloid plaques and neurofibrillary tangles in posterior brain regions are the most common underlying pathol- ogy, indicating that PCA most often represents a focal, mostly presenile variant of Alzheimer’s disease (AD) [4– 6]. One of the most sensitive and specific approaches to predict AD in vivo is the analysis of A  1–42 , T-tau and P- tau in the cerebrospinal fluid (CSF). When combined, the sensitivity and specificity for the diagnosis of AD have been found to be between 80 and 90% [6]. Analysis of these biomarkers may be helpful in predicting Alzhei- mer’s pathology also in PCA. In this study, we postulated that an AD-typical CSF protein profile consisting of low A  1–42 and high T-tau and P-tau 181 concentrations would also be observed in PCA patients. Methods Selection of Cases We identified 12 patients with PCA who were evaluated at the Center for Geriatric Medicine and Gerontology, University Hos- pital Freiburg, Germany, and the Memory Clinic of the Univer- Key Words Cognitive disorders  Dementia  Posterior cortical atrophy  Alzheimer’s disease  Cerebrospinal fluid  Biomarker  -amyloid  Tau Abstract Objective: Our purpose was to measure A  1–42 , T-tau and P-tau 181 in the cerebrospinal fluid (CSF) of patients with pos- terior cortical atrophy (PCA), a presenile dementia likely to represent a variant of Alzheimer’s disease (AD). Methods: CSF samples from 34 subjects including 9 patients with PCA, 11 age-matched patients with AD and 14 age-matched cog- nitively healthy controls were analyzed using commercially available ELISA kits. Results: The A  1–42 , T-tau and P-tau 181 levels in PCA patients differed significantly (p ! 0.02) from those in healthy controls but were indistinguishable from subjects with a clinical diagnosis of AD. Conclusion: High T- tau and P-tau 181 and low A  1–42 levels in PCA – typically ob- served in AD – indicate that the underlying pathology of PCA is usually AD. If these findings are replicated in PCA patients with autopsy-confirmed AD neuropathology, PCA patients may be eligible for disease-modifying AD treatments. Copyright © 2010 S. Karger AG, Basel Accepted: April 29, 2010 Published online: July 1, 2010 Thomas P. Baumann, MD Department of Neurology, University Hospital Petersgraben 4 CH–4031 Basel (Switzerland) Tel. +41 61 265 5431, Fax +41 61 265 3788, E-Mail th.baumann  @  unibas.ch © 2010 S. Karger AG, Basel 1420–8008/10/0296–0530$26.00/0 Accessible online at: www.karger.com/dem Downloaded by: Universitätsbibliothek Medizin Basel 131.152.211.61 - 10/23/2017 4:58:21 PM