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Informaciones
Psiquiátricas
2018 - n.º
232
preanalíticas y analíticas que podrían variar
el resultado de los biomarcadores en LCR
(especialmente beta), y que necesitan ser
mas estandarizadas entre diferentes labo-
ratorios, todas las contraindicaciones de la
PL. Asimismo, en la actualidad y a pesar que
en algunos centres de nuestro país esta téc-
nica ya está disponible, todavía no es gene-
ralizada en todos los centros asistenciales
de nuestro país.
Palabras clave:
Alzheimer, biomarcadors,
LCR, diagnostico, demencia, deterioro cogni-
tivo leve.
Abstract
In recent years, different scientific advan-
ces have made it possible to improve the
accuracy of the diagnosis of Alzheimer's di-
sease, as well as being able to establish it in
the early stages of the disease, even before
the onset of the dementia phase (prodromal
phase) where future modifying treatments of
the disease could have a greater therapeutic
interest. Among these diagnostic tools, are
the biomarkers of Alzheimer's disease, one
of which are the biomarkers in cerebrospinal
fluid (CSF). Currently in CSF at the care le-
vel we have the determination of
ŷ
-amyloid
proteins 42 and tau, in their total and phos-
phorylated forms, although at the research
level there are many others. Each of them is
altered in different evolutionary moments of
the disease and can provide us with different
information. Thus the alteration of
ŷ
-amyloid
42 (decrease in its levels in CSF) would indi-
cate a deposit of this protein at brain level,
which would start to occur years, even deca-
des, before the start of the clinic (preclinical
phases). therefore already altered before the
first symptoms (prodromal phase) and remai-
ning altered and relatively stable throughout
the evolution of the disease. On the other
hand, the alteration of tau (elevation of its
levels in CSF) would be more correlated with
the presence of neurofibrillary tangles and
would be markers of neurodegeneration, alte-
ring closer to the appearance of the sympto-
matology than
ŷ
-amyloid 42. In recent years
There are multiple studies that demonstrate
the usefulness of the determination of the-
se proteins in CSF to establish the diagnosis
of AD, which is why they have already been
incorporated into the new diagnostic crite-
ria criteria for NIA-AA in 2011. However, as
in any complementary exploration, its limi-
tations should also be known, among which
the possible preanalytical and analytical
variables that could vary the result of the
biomarkers in CSF (especially beta), and that
need to be more standardized among diffe-
rent laboratories, should be highlighted. all
the contraindications of the PL. Also, at pre-
sent and despite the fact that in some cen-
ters of our country this technique is already
available, it is still not generalized in all the
healthcare centers of our country..
Key Words:
Alzheimer, biomarkers, CSF,
diagnosis, dementia, mild cognitive impair-
ment.
Albert Lladó Plarrumaní