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Two‐level diagnostic classification using cerebrospinal fluid YKL‐40 in Alzheimer's disease
Author(s) -
Baldacci Filippo,
Toschi Nicola,
Lista Simone,
Zetterberg Henrik,
Blennow Kaj,
Kilimann Ingo,
Teipel Stefan,
Cavedo Enrica,
Santos Antonio Melo,
Epelbaum Stéphane,
Lamari Foudil,
Dubois Bruno,
Floris Roberto,
Garaci Francesco,
Bonuccelli Ubaldo,
Hampel Harald
Publication year - 2017
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.01.021
Subject(s) - cerebrospinal fluid , disease , medicine , alzheimer's disease , pathology
We assessed the diagnostic accuracy of cerebrospinal fluid (CSF) YKL‐40 in discriminating (1) clinical Alzheimer's disease (AD) from cognitively healthy controls (HCs) and frontotemporal dementia (FTD) (level I) and (2) patients stratified by different pathophysiological profiles from HCs and FTD following a novel unbiased/descriptive categorization based on CSF biomarkers, independent of cognitive impairment severity (level II). Methods YKL‐40 was compared among HCs ( n = 21), mild cognitive impairment ( n = 41), AD ( n = 35), and FTD ( n = 9) (level I) and among HCs ( n = 21), AD pathophysiology (tau and amyloid β) negative ( n = 15), tau positive ( n = 15), amyloid β positive ( n = 13), AD pathophysiology positive ( n = 33), and FTD ( n = 9) (level II). Results Level I: YKL‐40 discriminated AD from HC and FTD (area under the receiver operating characteristic curves [AUROCs] = 0.69, 0.71). Level II: YKL‐40 discriminated tau‐positive individuals and AD pathophysiology–positive individuals from HC, AD pathophysiology–positive patients from FTD (AUROCs = 0.76, 0.72, 0.73). Discussion YKL‐40 demonstrates fair performance in distinguishing tau‐positive patients from HCs, suggesting it may aid clinical diagnosis and support a biomarker‐guided pathophysiological stratification.