Spinal-Fluid Test Predicts Alzheimer’s with 100 Percent Accuracy
TweetUPenn researchers have just concluded an extensive study which shows that a spinal fluid test can be 100% accurate in identifying patients with memory loss who will eventually develop Alzheimer’s disease. The study which will publish today in the Archives of Neurology shows not just that a test can determine that a patient in on track to develop Alzheimer’s but also how accurate that test can be. The new study was comprised of over 300 individuals in their seventies: 114 with normal memories, 200 with memory problems, and 102 with Alzheimer’s disease. The spinal fluid of each participant was analyzed for a protein fragment called amyloid beta, which is known to form plaque in the brain, and a protein called tau, which builds up in dying brain nerve cells. The researchers analyzed each sample blind to the clinical status of each subject and patients were not informed of the results of their spinal tap test. The results? Almost three quarters of patients with mild cognitive impairment (a precursor to Alzheimer’s) had the proteins in their spinal fluid and all of those patients developed Alzheimer’s within five years. 1/3 of those patients with normal memories had the proteins in their spinal fluid, leading researchers to suspect those individuals will develop memory problems.
Study Shows Spinal Fluid Test for Alzheimer's Disease Successful
Scientists believe that Alzheimer’s is caused by accumulation of amyloid and tau which precipitates formation of amyloid plaques. They argue that stopping build-up of these proteins could halt the disease, but more research must be done on the effect of accumulation of these proteins in the brains of those with normal memories.
After years of research doctors now agree the onset of Alzheimer’s occurs a decade or more before an individual exhibits symptoms. By the time symptoms become noticeable it may be too late to treat the damage to the brain. Because of these facts, research has largely been targeted at identifying those who are developing the disease before symptoms appear and using them as subjects in studies of the hundreds of drugs that may stall progression of the disease. Until recently diagnosis of Alzheimer’s could only be confirmed at autopsy, but spinal fluid tests now join PET scans of the brain as tests which can confirm incidence of the disease.
New PET scans show the amyloid plaques in the brain that are indicative of Alzheimer’s. Although these PET scans are not commercially available, spinal fluid tests are. This fact opens up another world of questions and necessary research – scientists must make sure the tests are reliable if used in doctor’s offices (a.k.a. real-world situations) and they must confront the issue of whether doctors should test for a disease that is still untreatable. Essentially, how early should we label patients as future sufferers of Alzheimer’s? Some doctors suggest refraining from using the spinal fluid test as the results, though 100% accurate in research settings, have only been proven accurate in patients carefully selected to have no other conditions which could impair their brain function or memory. A false positive on a spinal fluid test could prove devastative to a real-world patient. Equally troublesome is the fact that patients with severe memory loss sometimes suffer not from Alzheimer’s but from another disease – a negative result on the spinal fluid test does not guarantee one might not suffer from another memory-loss condition later in life. As a result, researchers and doctors suggest not using the test except to confirm an Alzheimer’s diagnosis in patients with milder symptoms.
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