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Diagnostic and prognostic power of CSF Tau in amyotrophic lateral sclerosis

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Abstract

Background

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that still lacks reliable diagnostic biomarkers. This study aims to evaluate the diagnostic and prognostic potential of CSF total Tau (t-Tau), phospho-Tau (p-Tau) and p-Tau/t-Tau ratio in ALS patients using CSF neurofilament light (NFL) as the reference biomarker.

Methods

Eighty-five incident ALS, 30 ALS-mimicking (AM) diseases and 51 other non-neurodegenerative diseases (ONND) were included in the study.

Results

ALS patients had higher levels of CSF t-Tau and lower p-Tau/t-Tau ratio than AM (p = 0.005 and p = 0.006) and ONND (p < 0.001). CSF t-Tau levels discriminated ALS from AM with a sensitivity of 69% and specificity of 60%, and from ONND with a sensitivity of 88% and specificity of 51%. These values were lower than the accuracy of CSF NFL in ALS (sensitivity 86% and specificity 87% in distinguishing ALS from AM and sensitivity 83% and specificity 75% from ONND); CSF t-Tau correlated with progression rate and SNIP. CSF p-Tau did not show relation with any ALS clinical features. CSF NFL significantly correlated with all considered clinical parameters. High levels of CSF t-Tau and NFL were related to poor survival.

Conclusion

CSF t-Tau showed no reliable diagnostic significance but the relation between the high levels of CSF t-Tau and short survival suggests the potential prognostic role of this biomarker in ALS. However, CSF NFL was confirmed to be the most reliable and efficient tool for diagnosis and prediction of clinical progression and survival in ALS patients.

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Authors and Affiliations

  1. Neurology Unit, Department of Basic Medical Sciences, Neurosciences and Sense Organs (DBMSNSO), University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70100, Bari, Italy

    Antonio Scarafino, Eustachio D’Errico, Alessandro Introna, Angela Fraddosio, Eugenio Distaso, Irene Tempesta, Antonella Morea, Antonella Mastronardi & Isabella Laura Simone

  2. Neurophysiopathology Unit, Department of Basic Medical Sciences, Neurosciences and Sense Organs (DBMSNSO), University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70100, Bari, Italy

    Rosaria Leante, Maddalena Ruggieri & Mariangela Mastrapasqua

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  1. Antonio Scarafino
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  2. Eustachio D’Errico
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Correspondence to Isabella Laura Simone.

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Scarafino, A., D’Errico, E., Introna, A. et al. Diagnostic and prognostic power of CSF Tau in amyotrophic lateral sclerosis. J Neurol 265, 2353–2362 (2018). https://doi.org/10.1007/s00415-018-9008-3

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