Original Research Article
Clinical Features of Rapidly Progressive Alzheimer’s DiseaseSchmidt C.a · Redyk K.a · Meissner B.a · Krack L.a · von Ahsen N.b · Roeber S.c · Kretzschmar H.c · Zerr I.a
Departments of aNeurology and bClinical Chemistry, Hospital of the Georg August University Goettingen, Goettingen, and cDepartment of Neuropathology, Hospital of the Ludwig Maximilian University Munich, Munich, Germany
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Objective: To characterize clinical features, CSF biomarkers and genetic polymorphisms of patients suffering from a rapidly progressing subtype of Alzheimer’s dementia (rpAD). Methods: Retrospective analyses of 32 neuropathologically confirmed cases differentially diagnosed as AD out of a group with rapidly progressive dementia. CSF biomarkers (14-3-3, tau, β-amyloid 1–42) and genetic markers (PRNP codon 129, apolipoprotein E, ApoE, polymorphism) were determined. Results: Median survival was 26 months, age at onset 73 years. Biomarkers: mean β-amyloid 1–42: 266 pg/ml, median tau: 491 pg/ml, 14-3-3 positive: 31%. Genetic polymorphisms showed a predominance of methionine homozygosity at PRNP codon 129 and a low frequency of ApoE4 (38%, no homozygous patients). Thirty-five symptoms were studied. Frequent symptoms were myoclonus (75%), disturbed gait (66%) and rigidity (50%). Discussion: rpAD is associated with a diversity of neurological signs even able to mimic Creutzfeldt-Jakob disease. Biomarkers and genetic profile differ from those seen in classical AD. The findings on biomarkers, symptomatology and genetics may aid the differential diagnostic process.
© 2010 S. Karger AG, Basel
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