Cerebrospinal Fluid Biomarkers and Cognition in Alzheimer Disease and Frontotemporal Dementia in a Memory Clinic Setting

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Objective: Currently available literature on the relationships between cerebrospinal fluid (CSF) biomarkers and cognitive performance in frontotemporal dementia (FTD) is very limited and inconclusive. In this study, we investigated the association of cognitive symptoms, as measured with Montreal Cognitive Assessment (MoCA), with CSF levels of total tau (t-tau), phosphorylated tau at threonine 181 (p-tau181), and amyloid β 1–42 (Aβ1–42) in a group of patients with probable FTD and Alzheimer disease (AD). Methods: We conducted a retrospective cohort study with participants selected from the electronic records of patients seen at Yale New Haven Hospital’s Memory Clinic, CT. A total of 61 patients, 28 with FTD (mean age=64.1) and 33 with AD (mean age=66.8), with available CSF results and cognitive test scores in their chart were included in analyses. Results: T-tau levels negatively and significantly correlated with total MoCA scores as well as the different MoCA index scores in patients with FTD (r=−0.47, P=0.04). There were no significant associations between MoCA scores and p-tau181 levels in patients with FTD (r=−0.22, P=0.25). Patients with AD exhibited significant correlations between MoCA scores and both t-tau (r=−0.54, P<0.01) and p-tau (r=−0.55, P<0.01) levels. Also, Aβ1–42 levels were not significantly correlated with MoCA scores in either of the FTD and AD groups. Conclusion: CSF concentrations of t-tau are inversely correlated to cognitive performance in patients with FTD and both t-tau and p-tau181 in AD. This study provides valuable insights into the relationship between clinical cognitive performance and tau-related pathology in FTD in comparison with AD.