An CSF anomalous molecular form of acetylcholinesterase in demented and non‐demented subjects

ANALYSIS of 139 CSF samples from living subjects, using iso-electric focusing in polyacrylamide gels, demonstrated an anomalous molecular form of acetyl-cholinesterase (AChE). This form was present in 84 of 87 patients with a clinical diagnosis of Alzheimer's disease (AD), 28 of whom have died and in whom histopathological confirmation of AD was obtained. The abnormal AChE form was also present in 22 of 23 patients with clinical dementia not regarded as AD type. In the six patients who died this abnormal AChE form was found in three cases of multi-infarct dementia, one with cerebral glioma with dementia and one with clinical dementia, but no pathology was found based on the Khachaturian criteria for AD. One patient with normal pressure hydrocephalus was negative when tested for the abnormal AChE form. This evidence indicates that the anomalous molecular form of AChE may not be specific for AD, and may possibly be a common indicator for organic dementia. The discovery of this form in 27 of 29 age-matched non-demented controls may indicate that the anomalous molecular form of AChE may not only exist in patients with clinically detectable dementia, but is probably present for a period before the onset of dementia. Recognizing and understanding the existence of pre-clinical dementia would be beneficial in designing a strategy for both the prevention and the treatment of dementia.