HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Abdo, W. F. Articles by Verbeek, M. M. Search for Related Content PubMed PubMed Citation Articles by Abdo, W. F. Articles by Verbeek, M. M.

CSF analysis differentiates multiple-system atrophy from idiopathic late-onset cerebellar ataxia

From the Department of Neurology (W.F.A., B.P.C.v.d.W., M.M., B.R.B., H.P.H.K., M.M.V.) and Laboratory of Pediatrics and Neurology (W.J.A.v.G., M.M.V.), Radboud University Nijmegen Medical Centre, the Netherlands.

Address correspondence and reprint requests to Dr Abdo, Department of Neurology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands; e-mail: f.abdo{at}neuro.umcn.nl

Background: Differentiating idiopathic late-onset cerebellar ataxia (ILOCA) from ataxia due to the cerebellar subtype of multiple-system atrophy (MSA-C) can be difficult in the early stages of the disease

Methods: The authors analyzed the levels of various CSF biomarkers in 27 patients with MSA-C and 18 patients with ILOCA and obtained cut-off points for each potential biomarker to differentiate MSA-C from ILOCA.

Results: Increased levels of neurofilament light chain (NFL) and neurofilament heavy chain (NFHp35) and decreased levels of the neurotransmitter metabolites homovanillic acid (HVA), 5-hydroxyindoleaceticacid (5-HIAA), and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) were observed in MSA-C compared with ILOCA patients. Receiver operating characteristic analysis showed high sensitivity and specificity levels for NFL, NFHp35, and MHPG analysis. At a cut-off of 24.4 ng/L for the NFL analysis, a sensitivity of 79% and a specificity of 94% were obtained for differentiating MSA-C from ILOCA. At a cut-off point for NFHp35 of 129.5 ng/L, sensitivity was 87% and specificity 83%. Analysis of MHPG levels (cut-off 42.5 nM) resulted in a sensitivity of 86% with a specificity of 75%. A multivariate logistic regression model selected NFL, MHPG, and tau as independent predictive biomarkers that separated the MSA-C and ILOCA groups.

Conclusions: Increased levels of neurofilament light chain and tau and decreased levels of 3-methoxy-4-hydroxyphenylethyleneglycol were associated with high accuracy levels in differentiating the cerebellar subtype of multiple-system atrophy from idiopathic late-onset cerebellar ataxia (LOCA). CSF analysis may thus serve as a useful tool in early diagnostic differentiation of LOCA.

W.F.A was supported by a research grant of the Stichting Internationaal Parkinson Fonds.

Disclosure: The authors report no conflicts of interest.

Received September 19, 2005. Accepted in final form April 5, 2006.

This article has been cited by other articles:

				D de Jong, R W M M Jansen, Y A L Pijnenburg, W J A van Geel, G F Borm, H P H Kremer, and M M Verbeek CSF neurofilament proteins in the differential diagnosis of dementia J. Neurol. Neurosurg. Psychiatry, September 1, 2007; 78(9): 936 - 938. [Abstract] [Full Text] [PDF]

				M. D. Hoos, M. Ahmed, S. O. Smith, and W. E. Van Nostrand Inhibition of Familial Cerebral Amyloid Angiopathy Mutant Amyloid beta-Protein Fibril Assembly by Myelin Basic Protein J. Biol. Chem., March 30, 2007; 282(13): 9952 - 9961. [Abstract] [Full Text] [PDF]