Cerebrospinal fluid is key to early diagnosis of different types
11 October 2011
Different forms of dementia leave different biochemical
fingerprints in the cerebrospinal fluid before any clinical symptoms
emerge, researchers at the Sahlgrenska Academy in Sweden have
Differentiating between the various forms of dementia is crucial
for initiating appropriate treatment, and the new discovery paves
the way for more reliable diagnoses.
The two most common forms of dementia are Alzheimer's disease and
vascular dementia. The latter is caused by reduced circulation in
the small blood vessels of the brain, which can be picked up in
brain scans as small infarcts — strokes — or widespread changes in
the white matter. The problem is that this small vessel disease
presents very similarly to Alzheimer's disease, making it difficult
in practice to distinguish between the two.
Biochemical fingerprints in CSF
Because the different diseases are treated differently, it is
important to be able to make the correct diagnosis. Researcher Maria
Bjerke from the Sahlgrenska Academy at the University of Gothenburg
has shown in her thesis that the different forms of dementia are
detectable as biochemical changes in the cerebrospinal fluid (CSF)
long before any clinical symptoms emerge. The results are
significant for how the most common age-related cognitive disorders
Step towards better treatment
"As the CSF is in direct contact with the brain, its molecular
composition can be expected to reflect the brain's metabolism,"
Bjerke explains. "Examining the molecular fingerprints in the CSF
enables us to determine whether or not there is an ongoing
"Mapping the biochemical differences
between the various forms of dementia will help us to understand
what caused the disease, which in turn will determine how the
disease should be treated."
The possibility of differentiating between patients with mild
cognitive disorders due to small vessel disease and patients with
Alzheimer's needs to be given much greater attention, Bjerke
believes, not least with a view to designing and implementing
detailed treatment studies.