Abstract
AbstractDementia with Lewy Bodies (DLB) is the second most common form of dementia after Alzheimer’s disease (AD), accounting for 15-20 % of neuropathologically defined cases. Two-thirds of affected patients are not or are misdiagnosed due to the clinical similarity of the two pathologies. In this review, we are evaluating the ability of cerebrospinal fluid (CSF) biomarkers to differentiate DLB from AD. We first focus on biomarkers of AD used in clinical routine and then on biomarkers studied in research such as alpha-synuclein assay. Among the biomarkers of AD (t-TAU, phospho-TAU181, Aβ42 and Aβ40), t-TAU and phospho-TAU181 have shown excellent discrimination whatever the clinical stages severity. In patients with DLB, Aβ42 level is pathologic at the demented stage, but is almost unchanged in the prodromal stage of the disease. The assay of α-synuclein in CSF is also of interest to distinguish the two neurodegenerative pathologies but is of less value to separate subjects with DLB from individuals with other cognitive disorders. Thus, the analysis of CSF allows a differential diagnosis of both DLB and AD but the study of new biomarkers should improve it. Thus, we are also evaluating in the most exhaustive way possible all the biomarkers presenting a potential interest in this diagnosis.
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