Prognostic markers expanded for AD, ALS
medwireNews: Two studies expand the range of putative prognostic markers for neurological disease, with creatinine kinase (CK) found to be prognostic in amyotrophic lateral sclerosis (ALS) and neurogranin offering diagnostic and prognostic potential in Alzheimer’s disease (AD).
Muhammed Rafiq (University of Sheffield, UK) and colleagues report that each 1 unit rise in log serum CK was associated with a 26% reduction in mortality risk during 18 months of follow-up of 512 ALS patients. The association was independent of confounders including estimated lean body mass.
This and previous research suggest that change in CK levels over time, rather than baseline levels, are prognostic, says the team in the European Journal of Neurology.
The second study, in JAMA Neurology, found that levels of the postsynaptic neuronal protein neurogranin in the cerebrospinal fluid (CSF) differentiated between 95 patients with early symptomatic AD and 207 controls with an accuracy of 71% – comparable to the performance of tau and amyloid-β 1–42.
Moreover, higher baseline levels correlated with greater deterioration on a variety of cognitive tests during follow-up, leading researcher David Holtzman (Washington University School of Medicine, St Louis, Missouri, USA) and team to suggest it could be a useful surrogate marker of neuronal loss.
However, monitoring CSF neurogranin requires serial lumbar punctures, so, as noted by editorialists Steven DeKosky and Todd Golde, from University of Florida in Gainesville, USA, it “will likely remain for research and therapeutic trials”.
By Eleanor McDermid
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