A major study has confirmed the value of potential markers for identifying people with Alzheimer's disease. Scientists at the National Institute of Mental Health (NIMH) found that levels of two key indicators in spinal fluid distinguished clinically diagnosed Alzheimer's patients from controls with 89-92 percent efficiency. This matches or exceeds current clinical diagnostic methods, such as doctor's evaluation of medical history, cognitive testing, and brain scans. However, the potential telltale signs, or biomarkers, won't be ready for use as predictive and diagnostic tools until completion of long-term studies now underway. Trey Sunderland, M.D., chief, NIMH Geriatric Psychiatry Branch, and colleagues, report on their study -- which included both direct examination of 203 patients and controls and a meta-analysis of world literature -- in the April 23, 2003 Journal of the American Medical Association.

"We're hopeful that biomarkers will eventually be developed to help detect incipient illness in younger people who are at risk but who may not yet show any symptoms," said Sunderland. "Clues from biochemical, genetic and brain imaging studies could point to new possibilities for preventive interventions."

The NIMH study examined cerebrospinal fluid (CSF) levels of two protein fragments, hallmarks of the disease process, found in brains of Alzheimer's victims: beta-amyloid, which clumps together to form brain-damaging plaques, and tau, which strangles neurons in tangled filaments. Like many previous studies, it found that CSF beta amyloid levels drop, while tau levels rise in Alzheimer's. What's new is that the confidence level in this finding has now been boosted by applying a meta-analysis of the world literature and adding "the largest cohort of Alzheimer's disease patients and controls evaluated to date," say the researchers.

To gather their data, Sunderland and colleagues performed spinal taps on 136 Alzheimer's patients and 72 contr
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Contact: Jules Asher
NIMHpress@nih.gov
301-443-4536
NIH/National Institute of Mental Health
22-Apr-2003

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