The Relationship of Cerebrospinal Fluid Biomarkers and Cognitive Performance in Frontotemporal Dementia

Abstract

Objective: Currently available literature on the relationships between cerebrospinal fluid (CSF) biomarkers and cognitive performance in frontotemporal dementia (FTD) is very limited and inconclusive. In this study, we investigated the association of cognition, as measured with Montreal Cognitive Assessment (MoCA), with CSF levels of total tau (t-tau), phosphorylated tau at threonine 181 (p-tau₁₈₁), and amyloid β 1-42 (Aβ1-42) in a group of patients with FTD and Alzheimer's disease (AD).

Methods: We conducted a retrospective cohort study with participants selected from the electronic records of patients seen at Yale New Haven Hospital's Memory Clinic, CT, USA. We included 61 patients, 28 with FTD (mean age=64.1) and 33 with AD (mean age=66.8).

Results: T-tau levels negatively and significantly correlated with total MoCA scores as well as the different MoCA index scores in both the FTD (r=-0.469, p<0.05) and AD (r=-0.545, p<0.01) groups. There were no significant associations with MoCA scores and p-tau₁₈₁ levels in patients with FTD (r=-0.224, p>0.05), unlike patients with AD, who exhibited significant correlations (r=-0.549, p<0.01). Also, Aβ1-42 levels were not significantly correlated with MoCA scores in either of the FTD and AD groups.

Conclusion: CSF concentrations of t-tau are inversely correlated to cognitive performance in patients with FTD and both t-tau and p-tau₁₈₁ in AD. These findings provide valuable insights into the relationship between clinical cognitive performance and tau-related pathology in FTD.

Keywords: Alzheimer’s Disease; CSF; Cognitive decline; Frontotemporal dementia.

Figure 1

Scatterplots of the associations between t-tau, p-tau₁₈₁ levels, and Montreal Cognitive Assessment (MoCA) total scores. p-tau₁₈₁: Phosphorylated Tau at Threonine 181; t-tau: Total Tau. *: Correlations are significant at 0.05 level. **: Correlations are significant at 0.01 level.