The aim: To elucidate whether primarily atrophic degenerative impairment can be differentiated from the impairment of vascular origin by examining antibodies against fragments of the neuronal cytoskeleton in patients with dementia. Methods: A group of 37 patients with a syndrome of dementia involved 8 patients with Alzheimer's disease (AD), 8 patients with frontotemporal lobar degeneration (FTLD), 11 patients with vascular dementia (VD), and 10 patients with mixed dementia (MD).
A control group consisted of 10 subjects without disturbed cognitive functions. The diagnosis was established by means of basic clinical examinations, evaluations of MRI and of laboratory methods (determination of phospho-tau-protein, tau-protein, beta-amyloid in the cerebrospinal fluid).
The serums and cerebrospinal fluids (CSF) of these patients were examined using ELISA method for the presence of specific antibodies against the neuronal cytoskeleton, microtubular subunit - beta-tubulin (btcIII). Results: In the groups of patients with dementia the levels of IgM antibodies both in CSF and serum did not differ statistically significantly from those in the controls.
Positive titres of IgG anti-btcIII antibodies in CSF were found in 56% patients with VD, in 33% patients with IVID, and in 25% patients with FTLD. Positive titres of IgG antibodies against btcIII in serum were revealed in 40% patients with MD, in 36% patients with VD, and in 13% patients with FTLD.
No positive result of IgG antibodies in serum as well as in CSF was recorded in a group of patients with AD and in controls. Conclusion: Positive titres of antibodies of IgG class against btcIII in serum and CSF were detected in patients with VD and MD in contrast to patients with AD.
After verifying the results in a larger set of subjects, the examination of these specific antibodies can make the differential diagnosis of AD, MD and VD more accurate.