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Background: Cerebrospinal fluid (CSF) biomarkers have been increasingly studied in dementia clinical and differential diagnosis.

Methods: We assessed levels of total tau protein ([tau]T), tau phosphorylated at threonine 181 ([tau]P-181), and [beta]-amyloid1-42 (A[beta]42) in 34 patients with frontotemporal lobar degeneration (FTLD), 76 Alzheimer disease (AD) cases, and 93 controls (CTRL). Double sandwich enzyme-linked immunosorbent assays (Innogenetics) were used for measurements.

Results: Total [tau] was significantly increased and A[beta]42 decreased in FTLD and AD patients as compared with CTRL. CSF [tau]P-181 levels were significantly increased only in AD. The [tau]T/A[beta]42 ratio successfully discriminated FTLD from CTRL with a 86.7% specificity and 80.6% sensitivity, whereas the [tau]T alone was more specific (95.7%) but less sensitive (64.75%). For the discrimination of FTLD from AD, [tau]T/A[beta]42 ratio was better (90.3% sensitivity and 64.5% specificity) compared with the other biomarkers alone or in combination, whereas [tau]P-181 was less sensitive but more specific (68.4% and 85.7%, respectively). Subtype analysis revealed that the most AD-like profile of biomarkers were observed in FTLD with motor neuron signs, whereas the most non-AD profile were observed in patients with primary progressive aphasia.

Conclusions: Combined analysis of CSF biomarkers may be useful for the best possible antemortem discrimination of FTLD from AD.

(C) 2008 Lippincott Williams & Wilkins, Inc.