CSF placental growth factor – a novel candidate biomarker of frontotemporal dementia
2019
textabstractObjective: Diagnosis of frontotemporal dementia (FTD) is complicated by the
overlap of clinical symptoms with other dementia disorders. Development of
robust fluid biomarkers is critical to improve the diagnostic work-up of FTD.
Methods: CSF concentrations of placental growth factor (PlGF) were measured
in the discovery cohort including patients with FTD (n = 27), Alzheimer disease (AD) dementia (n = 75), DLB or PDD (n = 47), subcortical vascular
dementia (VaD, n = 33), mild cognitive impairment that later converted to AD
(MCI-AD, n = 34), stable MCI (sMCI, n = 62), and 50 cognitively healthy controls from the Swedish BioFINDER study. For validation, CSF PlGF was measured in additional independent cohort of FTD patients (n = 22) and controls
(n = 18) from the Netherlands. Results: In the discovery cohort, MCI, MCIAD, AD dementia, DLB-PDD, VaD, and FTD patients all showed increased
CSF levels of PlGF compared with controls (sMCI P = 0.019; MCI-AD
P = 0.005; AD dementia, DLB-PDD, VaD, and FTD all P < 0.001). PlGF levels
were 1.8–2.1-fold higher in FTD than in AD, DLB-PDD and VaD (all
P < 0.001). PlGF distinguished with high accuracy FTD from controls and
sMCI performing better than tau/Ab42 (AUC 0.954–0.996 versus 0.564–0.754,
P < 0.001). A combination of PlGF, tau, and Ab42 (tau/Ab42/PlGF) was more
accurate than tau/Ab42 when differentiating FTD from a group of other
dementias (AUC 0.972 vs. 0.932, P < 0.01). Increased CSF levels of PlGF in
FTD compared with controls were corroborated in the validation cohort. Interpretation: CSF PlGF is increased in FTD compared with other dementia disorders, MCI, and healthy controls and might be useful as a diagnostic biomarker
of FTD.
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