CSF biomarkers predict a more malignant outcome in Alzheimer disease
Wallin AK, Blennow K, Zetterberg H, Londos E, Minthon L, Hansson O.. Neurology, 2010-05-01
Topic: Amyloid, tau and blood-test diagnosis
Objective To investigate if patterns of CSF biomarkers (T-tau, P-tau, and Abeta42) can predict cognitive progression, outcome of cholinesterase inhibitor (ChEI) treatment, and mortality in Alzheimer disease (AD). Methods We included outpatients with AD (n = 151) from a prospective treatment study with ChEI. At baseline, patients underwent cognitive assessments and lumbar puncture. The patients were assessed longitudinally. The 5-year survival rate was evaluated. CSF-Abeta42, T-tau, and P-tau were analyzed at baseline. K-means cluster analysis including the 3 CSF biomarkers was carried out. Results Cluster 1 contained 87 patients with low levels of Abeta42 and relatively low levels of T-tau and P-tau. Cluster 2 contained 52 patients with low levels of Abeta42 and intermediate levels of T-tau and P-tau. Cluster 3 contained 12 patients with low levels of Abeta42 and very high levels of CSF T-tau and P-tau. There were no differences between the clusters regarding age, gender, years of education, baseline instrumental activities of daily living, or APOE genotype. Even though there was no difference between cluster 3 and the other clusters in disease duration or global rating, the patients in cluster 3 performed worse on cognitive tests already at baseline. Patients in cluster 3 exhibited a very poor outcome of ChEI treatment. Finally, cognition deteriorated faster over time and the mortality rate was substantially increased in cluster 3. Conclusion A subgroup of patients with Alzheimer disease with extreme levels of CSF biomarkers exhibits worse clinical outcomes over time, including faster progression of cognitive deficits, no response to ChEI treatment, and a higher mortality.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Wallin, A. K., Blennow, K., Zetterberg, H., Londos, E., Minthon, L., & Hansson, O. (2010). CSF biomarkers predict a more malignant outcome in Alzheimer disease. Neurology. https://doi.org/10.1212/wnl.0b013e3181dd4dd8
Vancouver
Wallin AK, Blennow K, Zetterberg H, Londos E, Minthon L, Hansson O. CSF biomarkers predict a more malignant outcome in Alzheimer disease. Neurology. 2010. doi:10.1212/wnl.0b013e3181dd4dd8. PMID: 20458070.
BibTeX
@article{wallin2010-20458070,
author = {Wallin, A. K. and Blennow, K. and Zetterberg, H. and Londos, E. and Minthon, L. and Hansson, O.},
title = {{CSF biomarkers predict a more malignant outcome in Alzheimer disease}},
journal = {Neurology},
year = {2010},
doi = {10.1212/wnl.0b013e3181dd4dd8},
pmid = {20458070},
url = {https://doi.org/10.1212/wnl.0b013e3181dd4dd8}
}
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Key findings
- Results Cluster 1 contained 87 patients with low levels of Abeta42 and relatively low levels of T-tau and P-tau.
Why it matters
Among people already diagnosed with Alzheimer's disease, a pattern of spinal fluid markers with very high T-tau and P-tau was linked to worse thinking at the start, faster decline, poorer response to cholinesterase inhibitor treatment, and shorter survival. This is about predicting outcomes in existing disease, not about treating or preventing it.
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Study details
- Participants151
- Evidence strengthLow
How this study scored 55/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2010 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 151 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 223 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.4 citations a year over 18 year(s) since 2010 |
| Impact for its field and year | 4 / 6 | Cited 11.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 20 other studies in this library |
| Still being cited | 2 / 4 | Cited 27 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Oskar Hansson: h-index 148 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Lund University: institution h-index 1,119 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 20458070) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 55 / 100 | — |
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