Differential CSF Biomarker Levels in APOE-ε4-Positive and -Negative Patients with Memory ImpairmentAndersson C.a, b · Blennow K.d · Johansson S.-E.a · Almkvist O.a, b, c · Engfeldt P.e · Lindau M.f · Eriksdotter-Jönhagen M.a
aDepartment of Neurobiology, Caring Sciences and Society, Karolinska Institutet, bDepartment of Psychology, Karolinska University Hospital Huddinge, and cDepartment of Psychology, Stockholm University, Stockholm, dClinical Neurochemistry Laboratory, Department of Clinical Neuroscience, University of Göteborg, Göteborg, eDepartment of Clinical Medicine, Family Medicine Research Centre, Örebro University, Örebro, and fDepartment of Public Health and Caring Sciences/Geriatrics, Uppsala University Hospital, Uppsala, Sweden
Objectives: To investigate the relationships between episodic memory, APOE genotype, CSF markers (total tau, T-tau; phospho-tau, P-tau; β-amyloid, Aβ42) and longitudinal cognitive decline. Methods: 124 memory clinic patients were retrospectively divided into 6 groups based on (i) episodic memory function (Rey Auditory Verbal Learning Test, RAVLT): severe, moderate or no impairment (SIM, MIM or NIM), and (ii) APOE genotype (ε4+ or ε4–). CSF marker levels and cognitive decline were compared across groups. Results: Episodic memory function, according to RAVLT scores, was significantly correlated with CSF marker levels only among ε4+ subjects and not among ε4– subjects. When comparing the 6 subgroups, SIM ε4+ and MIM ε4+ groups showed significantly lower Aβ42 levels than the other groups. T-tau and P-tau levels were significantly increased in SIM ε4+ when compared to all the other groups, including the SIM ε4– group. However, both SIM ε4+ and SIM ε4– declined cognitively during the follow-up. Conclusion: It remains to be determined whether APOE genotype affects the expression of biomarkers in CSF, or whether the different biomarker patterns reflect different types of disease processes in patients with progressive cognitive dysfunction.
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