A Fourier1,2, M Formaglio3,4, F Kaczorowski1,2, H Mollion4,5, A Perret-Liaudet1,2, M Sauvee6, I Quadrio1,2. 1. Biochemistry Department, Lyon University Hospital, Lyon, France. 2. Lyon Neuroscience Research Center BIORAN Team - CNRS UMR 5292, INSERM U1028, Université de Lyon, Lyon, France. 3. Neurocognition and Neuro-ophthalmology Department, Lyon University Hospital, Lyon, France. 4. Centre Mémoire de Ressources et de Recherche de Lyon, Lyon, France. 5. Neuropsychology Department, Lyon University Hospital, Lyon, France. 6. Neurology Department, Grenoble Alpes University Hospital, Grenoble, France.
Abstract
BACKGROUND AND PURPOSE: Neuropsychiatric symptoms are commonly observed in neurodegenerative diseases. No biomarker is currently available to diagnose psychiatric conditions. As a consequence, the distinction between psychiatric and neurodegenerative disorders can be challenging in daily practice. METHODS: This retrospective study included a cohort of 64 primary psychiatric patients (PSY) and 162 patients suffering from various neurodegenerative disorders (NDG). Total tau (t-Tau), phosphorylated tau (p-Tau), Aβ1-42 peptide (Aβ1-42) and neurofilament light chain protein (NfL) were analysed in cerebrospinal fluid. The discrimination between PSY and NDG patients was assessed using both individual and combined analysis of cerebrospinal fluid markers. RESULTS: Cerebrospinal fluid t-Tau and NfL exhibited the best diagnostic performances: they were able to discriminate between PSY and each subgroup of NDG patients. t-Tau had the highest sensitivity (93.8%) but a poor specificity (67.3%). Indeed, some NDG subgroups exhibited low t-Tau levels comparable to PSY patients. A sequential combination t-Tau + NfL improved the characterization of patients, especially in these particular subgroups, increasing specificity up to 89.6% without modification of sensitivity. Finally, this combination of markers led to a high classification rate of 90.7% for the whole cohort of patients. CONCLUSION: The sequential combination t-Tau + NfL enables the biological detection of neurodegeneration in patients with psychiatric features. This association of markers seems to be a promising strategy for a differential diagnosis in clinical practice between primary psychiatric conditions and neurodegenerative disorders, thus improving medical care of patients.
BACKGROUND AND PURPOSE: Neuropsychiatric symptoms are commonly observed in neurodegenerative diseases. No biomarker is currently available to diagnose psychiatric conditions. As a consequence, the distinction between psychiatric and neurodegenerative disorders can be challenging in daily practice. METHODS: This retrospective study included a cohort of 64 primary psychiatricpatients (PSY) and 162 patients suffering from various neurodegenerative disorders (NDG). Total tau (t-Tau), phosphorylated tau (p-Tau), Aβ1-42 peptide (Aβ1-42) and neurofilament light chain protein (NfL) were analysed in cerebrospinal fluid. The discrimination between PSY and NDGpatients was assessed using both individual and combined analysis of cerebrospinal fluid markers. RESULTS: Cerebrospinal fluid t-Tau and NfL exhibited the best diagnostic performances: they were able to discriminate between PSY and each subgroup of NDGpatients. t-Tau had the highest sensitivity (93.8%) but a poor specificity (67.3%). Indeed, some NDG subgroups exhibited low t-Tau levels comparable to PSY patients. A sequential combination t-Tau + NfL improved the characterization of patients, especially in these particular subgroups, increasing specificity up to 89.6% without modification of sensitivity. Finally, this combination of markers led to a high classification rate of 90.7% for the whole cohort of patients. CONCLUSION: The sequential combination t-Tau + NfL enables the biological detection of neurodegeneration in patients with psychiatric features. This association of markers seems to be a promising strategy for a differential diagnosis in clinical practice between primary psychiatric conditions and neurodegenerative disorders, thus improving medical care of patients.