Background: There is a need for biomarkers of dementia in PD.

Objectives: To determine if the levels of the main CSF proteins and their ratios are associated with deterioration in cognition and progression to dementia in the short to mid term.

Methods: The Parkinson’s Progression Markers Initiative database was used as an exploratory cohort, and a center‐based cohort was used as a replication cohort. Amyloid ß1‐42, total tau, threonine‐181 phosphorylated tau, and α‐synuclein in the CSF and the ratios of these proteins were assessed.

Results: In the Parkinson’s Progression Markers Initiative cohort (n = 281), the total tau/amyloid ß1‐42, total tau/α‐synuclein, total tau/amyloid ß1‐42+α‐synuclein, and amyloid ß1‐42/total tau ratios were associated with a risk of progression to dementia over a 3‐year follow‐up. In the replication cohort (n = 40), the total tau/α‐synuclein and total tau/amyloid ß1‐42+α‐synuclein ratios were associated with progression to dementia over a 41‐month follow‐up.

Conclusion: Ratios of the main proteins found in PD patient brain inclusions that can be measured in the CSF appear to have value as short‐ to mid‐term predictors of dementia. © 2018 International Parkinson and Movement Disorder Society


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