Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector99010.54101/ACEN.2023.3.3Original articlesОригинальные статьиResearch ArticleBiochemical markers of neurodegeneration in patients with cerebral small vessel disease and Alzheimer's diseaseБиохимические маркеры нейродегенерации при церебральной микроангиопатии (болезни мелких сосудов) и болезни Альцгеймераhttps://orcid.org/0000-0001-9929-2725DobryninaLarisa A.ДобрынинаЛариса Анатольевна
Russian Federation

D. Sci. (Med.), chief researcher, Head, 3rd Neurological department, Institute of Clinical and Preventive Neurology, Research Center of Neurology, Moscow, Russia

д.м.н., г.н.с., руководитель 3-го неврологического отделения Института клинической и профилактической неврологии ФГБНУ «Научный центр неврологии», Москва, Россия

dobrla@mail.ruhttps://orcid.org/0000-0002-4231-3895TsypushtanovaMaria M.ЦыпуштановаМария Михайловна
Russian Federation

postgraduate student, neurologist, 3rd Neurological department, Institute of Clinical and Preventive Neurology, Research Center of Neurology, Moscow, Russia

аспирант, врач-невролог 3-го неврологического отделения Института клинической и профилактической неврологии ФГБНУ «Научный центр неврологии», Москва, Россия

tzipushtanova@mail.ruhttps://orcid.org/0000-0001-9604-7775ShabalinaАlla A.ШабалинаАлла Анатольевна
Russian Federation

D. Sci. (Med.), leading researcher, Head, Department of laboratory diagnostics, Research Center of Neurology, Moscow, Russia

д.м.н., в.н.с., руководитель отдела лабораторной диагностики Института клинической и профилактической неврологии ФГБНУ «Научный центр неврологии», Москва, Россия

ashabalina@yandex.ruhttps://orcid.org/0000-0002-6995-1352ShamtievaKamila V.ШамтиеваКамила Витальевна
Russian Federation

Cand. Sci. (Med.), researcher, 3rd Neurological department, Institute of Clinical and Preventive Neurology, Research Center of Neurology, Moscow, Russia

к.м.н., н.с. 3-го неврологического отделения Института клинической и профилактической неврологии ФГБНУ «Научный центр неврологии», Москва, Россия

kamila.shamt@gmail.comhttps://orcid.org/0000-0001-8862-654XMakarovaAngelina G.МакароваАнгелина Геннадьевна
Russian Federation

postgraduate student, neurologist, 3rd Neurological department, Institute of Clinical and Preventive Neurology, Research Center of Neurology, Moscow, Russia

ирант, врач-невролог 3-го неврологического отделения Института клинической и профилактической неврологии ФГБНУ «Научный центр неврологии», Москва, Россия

angelinagm@mail.ruhttps://orcid.org/0000-0001-7898-6541TrubitsynaViktoria V.TрубицынаВиктория Владимировна
Russian Federation

postgraduate student, radiologist, Department of radiation diagnostics, Research Center of Neurology, Moscow, Russia

аспирант, врач-рентгенолог отделения лучевой диагностики ФГБНУ «Научный центр неврологии», Москва, Россия

pobeda-1994@mail.ruhttps://orcid.org/0000-0003-1464-0722BitsievaElina T.БициеваЭлина Таймуразовна
Russian Federation

postgraduate student, neurologist, 3rd Neurological department, Institute of Clinical and Preventive Neurology, Research Center of Neurology, Moscow, Russia

аспирант, врач-невролог 3-го неврологического отделения Института клинической и профилактической неврологии ФГБНУ «Научный центр неврологии», Москва, Россия

elinabitsieva1997@mail.ruhttps://orcid.org/0000-0002-2285-2533ByrochkinaAleksandra A.БырочкинаАлександра Андреевна
Russian Federation

postgraduate student, neurologist, 3rd Neurological department, Institute of Clinical and Preventive Neurology, Research Center of Neurology, Moscow, Russia

аспирант, врач-невролог 3-го неврологического отделения Института клинической и профилактической неврологии ФГБНУ «Научный центр неврологии», Москва, Россия

byrochkinasasha@mail.ruhttps://orcid.org/0009-0001-1836-2515GeintsAnastasia A.ГейнцАнастасия Александрова
Russian Federation

resident of the 6rd neurological department of the Research Center of Neurology

ординатор 6-го неврологического отделения ФГБНУ НЦН

anastasiyatarasova75@gmail.comResearch Center of NeurologyФГБНУ «Научный центр неврологии»Lomonosov Moscow State UniversityФГБОУ ВО «Московский государственный университет имени М.В. Ломоносова»2909202317321301205202314062023Copyright ©; 2023, Dobrynina L.A., Tsypushtanova M.M., Shabalina А.A., Shamtieva K.V., Makarova A.G., Trubitsyna V.V., Bitsieva E.T., Byrochkina A.A., Geints A.A.Copyright ©; 2023, Добрынина Л.А., Цыпуштанова М.М., Шабалина А.А., Шамтиева К.В., Макарова А.Г., Tрубицына В.В., Бициева Э.Т., Бырочкина А.А., Гейнц А.А.2023Dobrynina L.A., Tsypushtanova M.M., Shabalina А.A., Shamtieva K.V., Makarova A.G., Trubitsyna V.V., Bitsieva E.T., Byrochkina A.A., Geints A.A.Добрынина Л.А., Цыпуштанова М.М., Шабалина А.А., Шамтиева К.В., Макарова А.Г., Tрубицына В.В., Бициева Э.Т., Бырочкина А.А., Гейнц А.А.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/990

Introduction. Cerebral small vessel disease (CSVD) as well as the Alzheimer's disease (AD) and their comorbidities are the most common causes of cognitive impairments (CIs).

Objective: to evaluate the predictive power of the biochemical neurodegeneration markers in patients with CSVD and AD.

Materials and methods. We assessed the following neurodegeneration markers in 68 patients with CSVD (61.0 ± 8.6 years; 60.3% males), 17 patients with AD (65.2 ± 8.3 years; 35.3% males), and 26 healthy volunteers (59.9 ± 6.7 years; 38.5% males): neuron-specific enolase (NSE), glial fibrillary acid protein (GFAP), neurofilament light polypeptide (NEFL) in blood (for all patients) and in cerebrospinal fluid (CSF; in patients with CSVD and AD). We assessed the predictive power of those markers with ROC analysis.

Results. As compared to the control group, serum GFAP in patients with CSVD showed its predictive power at 0.155 ng/ml (sensitivity 74%; specificity 70%). Serum NEFL > 0.0185 ng/ml (sensitivity 82%; specificity 96%) and NSE < 4.95 μg/ml (sensitivity 77%; specificity 71%) showed their predictive power in patients with AD. CSF GFAP > 1.03 ng/ml (sensitivity 84%; specificity 88%), CSF NSE < 19.10 μg/ml (sensitivity 88%; specificity 91%), serum NEFL < 0.021 ng/ml (sensitivity 71%; specificity 76%), serum NSE /CSF NSE ratio > 0.273 ng/ml (sensitivity 87%; specificity 88%) help differentiate CSVD from AD.

Conclusions. We found that serum GFAP can be a useful diagnostic marker in patients with CSVD, while serum NEFL and serum NSE can help identify the AD. In addition, CSF GFAP and CSF NSE as well as serum NEFL and serum NSE/CSF NSE can help differentiate CSVD from AD. We can use those markers in clinical and research practice to identify the vascular and neurodegenerative causes of CIs and their comorbidities, which is of a great importance in developing specific treatment and predicting the course of the disease.

Введение. Церебральная микроангиопатия (ЦМА), болезнь Альцгеймера (БА) и их коморбидные формы являются основными причинами когнитивных расстройств (КР).

Цель исследования — определить предиктивную роль биохимических маркеров нейродегенерации при ЦМА и БА.

Материалы и методы. У 68 пациентов с ЦМА (61,0 ± 8,6 года; мужчин 60,3%), 17 — с БА (65,2 ± 8,3 года; мужчин 35,3%) и 26 здоровых добровольцев (59,9 ± 6,7 года; мужчин 38,5%) исследовались маркеры нейродегенерации: нейронспецифическая энолаза (NSE), глиофибриллярный белок (GFAP), лёгкие цепи нейрофиламентов (NEFL) в крови во всех группах и в цереброспинальной жидкости (ЦСЖ) при ЦМА и БА. Предиктивность показателей оценивали ROC-анализом.

Результаты. При ЦМА различия с контролем и диагностическая предиктивность установлены для GFAP > 0,155 нг/мл в крови (чувствительность — 74%, специфичность — 70%), при БА — для NEFL > 0,0185 нг/мл в крови (чувствительность — 82%, специфичность — 96%), NSE < 4,95 мкг/мл (чувствительность — 77%, специфичность — 71%). Дифференцирование ЦМА от БА возможно по уровням GFAP в ЦСЖ > 1,03 нг/мл (чувствительность — 84%, специфичность — 88%), NSE в ЦСЖ < 19,10 мкг/мл (чувствительность — 88%, специфичность — 91%), NEFL в крови < 0,021 нг/мл (чувствительность — 71%, специфичность — 76%), коэффициенту NSE кровь/ЦСЖ > 0,273 нг/мл (чувствительность — 87%, специфичность — 88%).

Выводы. Предиктивные характеристики исследуемых биохимических показателей позволяют рассматривать в качестве диагностических маркеров отклонения от пороговых величин при ЦМА — GFAP в крови, при БА — NEFL и NSE в крови, а в качестве дифференцирующих ЦМА от БА — GFAP и NSE в ЦСЖ, NEFL в крови, NSE в крови/ЦСЖ. Использование данных маркеров в исследовательской и клинической практике позволит дифференцировать сосудистые и нейродегенеративные причины КР и их коморбидность, что является крайне важным в разработке патогенетической терапии и прогнозировании течения заболевания.

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