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RESEARCH PRODUCT

Cerebrospinal Fluid Tau Protein Levels and <sup>18</sup>F-Fluorodeoxyglucose Positron Emission Tomography in the Differential Diagnosis of Alzheimer’s Disease

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<i>Aims:</i> In this study, we aimed to compare cerebrospinal fluid (CSF) levels of total tau (t-tau), phosphorylated tau (p-tau<sub>181</sub>) and positron emission tomography with <sup>18</sup>F-fluorodeoxyglucose (FDG-PET) in the differential diagnosis of Alzheimer’s disease (AD) under clinical conditions. <i>Method:</i> In a cross-sectional, blinded, single-center study, we examined a sample of 75 unselected memory clinic patients with clinical diagnoses of dementia of Alzheimer type (DAT; n = 24), amnestic mild cognitive impairment (MCI; n = 16), other dementias (n = 13) and nondemented controls (n = 22). Discriminative accuracy, sensitivity and specificity were calculated and compared using ROC analyses. <i>Results:</i> p-tau<sub>181</sub> and FDG-PET were comparable in separating DAT from controls (sensitivity: 67 vs. 79%; specificity: 91% for both) and patients with other dementias (sensitivity: 71 vs. 79%; specificity: 100% for both). The sensitivity of p-tau<sub>181</sub> in differentiating MCI patients from controls was significantly (p < 0.05) superior to that of FDG-PET (75 vs. 44%) at a comparably high specificity (82 vs. 91%); t-tau measures were less accurate in all analyses. <i>Conclusions:</i> FDG-PET and CSF p-tau<sub>181</sub> levels are able to discriminate DAT in heterogeneous and unselected samples with a high accuracy. CSF p-tau<sub>181</sub> might be somewhat superior for a sensitive detection of patients with MCI.