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Abstract Details

Patterns of CSF Biomarkers of Alzheimer’s Disease in Specialty Behavioral Neurology Practices
Behavioral and Cognitive Neurology
S2 - Behavioral Neurology (1:48 PM-2:00 PM)
005

Low CSF Amyloid Beta-42 (Ab42) and elevated Phosphorylated-Tau (pTau), total-Tau (tTau), and pTau/Ab42 ratio (PTAR) are considered markers of AD pathology with variable predictive values.  The presentation of AD CSF biomarkers in a spectrum of non-AD degenerative or nondegenerative cognitive disorders such as normal pressure hydrocephalus (NPH) is poorly understood.   The objective of this study was to assess patterns of CSF biomarkers in a tertiary practice. 

To describe patterns of Alzheimer’s Disease (AD) Cerebrospinal Fluid (CSF) biomarkers at the Mayo Clinic.

535 patients underwent an in-house Roche Elecsys AD CSF biomarker test as a part of a cognitive evaluation over a 1-year period. Patients were retrospectively assigned a clinical diagnosis based solely on clinical presentation and examination according to published criteria by a behavioral neurologist blinded to imaging and CSF testing. Associations between blinded clinical diagnoses and CSF biomarkers were carried out via a Chi-squared test of independence and post-hoc Pearson’s residuals with Bonferroni correction.

27% of patients had zero biomarkers consistent with AD; 25% had four biomarkers consistent with AD. There was an association between clinical diagnoses and biomarker profiles, χ2 (48, N = 535) = 310, p < .001.  Abnormal PTAR was positively associated with AD-Dementia but negatively with NPH (p.adj < .05). PTAR was also abnormal in 57% of amnestic-MCI, 31% of Dementia with Lewy Bodies, 23% of Corticobasal Syndrome, and 20% of other Frontotemporal Lobar Degeneration Spectrum patients. Isolated low/abnormal Ab42 was positively associated with NPH but negatively with AD-Dementia (p.adj < .05).

Among CSF AD biomarker measures from a behavioral practice, abnormal PTAR displayed the strongest relationship with AD-type dementia. Normal PTAR with low/abnormal Ab42 was robustly associated with NPH.  Abnormal PTAR in non-AD neurodegenerative disorders may reflect established frequency of AD co-pathology in these syndromes, although further analysis of biomarker performance is needed.
Authors/Disclosures
Wentao Li, MD (The Permanente Medical Group)
PRESENTER 		Dr. Li has nothing to disclose.
Ronald C. Petersen, MD, PhD, FAAN (Mayo Clinic) Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Nestle. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co.. Dr. Petersen has received personal compensation in the range of $0-$499 for serving as a Consultant for Eisai, Inc.. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has a non-compensated relationship as a Board of Directors with American Brain Foundation that is relevant to AAN interests or activities.
Alicia Algeciras-Schimnich No disclosure on file
No disclosure on file
Bradley F. Boeve, MD, FAAN (Mayo Clinic) Dr. Boeve has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rainwater Charitable Foundation. The institution of Dr. Boeve has received research support from Alector. The institution of Dr. Boeve has received research support from EIP Pharma. The institution of Dr. Boeve has received research support from Transposon. The institution of Dr. Boeve has received research support from Cognition Therapeutics. Dr. Boeve has received publishing royalties from a publication relating to health care.
David T. Jones, MD (Mayo Clinic) Dr. Jones has received intellectual property interests from a discovery or technology relating to health care.
Hugo Botha, MD (Mayo School of Graduate Medical Education, Rochester) Dr. Botha has received research support from NIH.
Vijay K. Ramanan, MD, PhD (Mayo Clinic) The institution of Dr. Ramanan has received research support from the National Institutes of Health. The institution of Dr. Ramanan has received research support from the Mangurian Foundation for Lewy Body Disease Research. The institution of Dr. Ramanan has received research support from as part of clinical trials sponsored by the Alzheimer's Association, Eisai, the Alzheimer's Treatment and Research Institute at USC, and Transposon Therapeutics, Inc.. The institution of Dr. Ramanan has received research support from Medscape. Dr. Ramanan has received personal compensation in the range of $500-$4,999 for serving as a Conference Speaker/Organizer (Honoraria) with AANI.
David S. Knopman, MD, FAAN (Mayo Clinic) Dr. Knopman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for DIAN TU study. The institution of Dr. Knopman has received research support from NIH.
Rodolfo Savica, MD, PhD, FAAN (Mayo Clinic) The institution of Dr. Savica has received research support from ACADIA Pharmaceuticals, Inc.
Keith A. Josephs, Jr., MD, FAAN (Mayo Clinic) Dr. Josephs has nothing to disclose.
Christine Cliatt Brown, MD (University of Utah) Dr. Cliatt Brown has nothing to disclose.
Gregory S. Day, MD, MSc, FAAN (Mayo Clinic) Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Parabon Nanolabs. The institution of Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys Therapeutics. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ionis. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for DynaMed (EBSCO Health). Dr. Day has stock in ANI Pharmaceuticals. The institution of Dr. Day has received research support from National Institutes of Health / NIA. The institution of Dr. Day has received research support from Chan Zuckerberg Initiative. The institution of Dr. Day has received research support from Alzheimer's Association. The institution of Dr. Day has received research support from National Institutes of Health / NINDS. The institution of Dr. Day has received research support from Horizon Therapeutics. The institution of Dr. Day has received research support from AVID Radiopharmaceuticals. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Presenter at Annual Meeting (CME) with American Academy of Neurology. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Content Development (CME) with PeerView, Inc. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Content Development (CME) with Continuing Education, Inc. Dr. Day has a non-compensated relationship as a Clinical Director with AntiNMDA Receptor Encephalitis Foundation that is relevant to AAN interests or activities.
Neill R. Graff-Radford, MD, FAAN (Mayo Clinic Jacksonville) The institution of Dr. Graff-Radford has received research support from Biogen. The institution of Dr. Graff-Radford has received research support from Lilly. The institution of Dr. Graff-Radford has received research support from Novartis. The institution of Dr. Graff-Radford has received research support from AbbVie. Dr. Graff-Radford has received publishing royalties from a publication relating to health care.
Nilufer Taner, MD, PhD, FAAN (Mayo Clinic) The institution of Dr. Taner has received research support from NIH.
Bryan K. Woodruff, MD (Mayo Clinic) The institution of Dr. Woodruff has received research support from National Institute on Aging.
Richard J. Caselli, MD, FAAN (Mayo Clinic) The institution of Dr. Caselli has received research support from NIA. The institution of Dr. Caselli has received research support from State of Arizona.
Jonathan Graff-Radford, MD, FAAN Dr. Graff-Radford has received personal compensation for serving as an employee of Mayo Clinic. Dr. Graff-Radford has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NINDS/NIH. The institution of Dr. Graff-Radford has received research support from NIH. The institution of Dr. Graff-Radford has received research support from Eisai. The institution of Dr. Graff-Radford has received research support from Cognition therapeutics.