TY - JOUR
T1 - Clinical application of CSF biomarkers for Alzheimer's disease
T2 - From rationale to ratios
AU - Bouwman, Femke H.
AU - Frisoni, Giovanni B.
AU - Johnson, Sterling C.
AU - Chen, Xiaochun
AU - Engelborghs, Sebastiaan
AU - Ikeuchi, Takeshi
AU - Paquet, Claire
AU - Ritchie, Craig
AU - Bozeat, Sasha
AU - Quevenco, Frances-Catherine
AU - Teunissen, Charlotte
PY - 2022
Y1 - 2022
N2 - Biomarker testing is recommended for the accurate and timely diagnosis of Alzheimer's disease (AD). Using illustrative case narratives we consider how cerebrospinal fluid (CSF) biomarker tests may be used in different presentations of cognitive impairment to facilitate timely and differential diagnosis, improving diagnostic accuracy, providing prognostic information, and guiding personalized management in diverse scenarios. Evidence shows that (1) CSF ratios are superior to amyloid beta (Aβ)1-42 alone; (2) concordance of CSF ratios to amyloid positron emission tomography (PET) is better than Aβ1-42 alone; and (3) phosphorylated tau (p-tau)/Aβ1-42 ratio is superior to p-tau alone. CSF biomarkers are recommended for the exclusion of AD as the underlying cause of cognitive impairment, diagnosis of AD at an early stage, differential diagnosis of AD in individuals presenting with other neuropsychiatric symptoms, accurate diagnosis of AD in an atypical presentation, and for clinical trial enrichment. Highlights: Cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarker testing may be underused outside specialist centers. CSF biomarkers improve diagnostic accuracy, guiding personalized management of AD. CSF ratios (amyloid beta [Aβ]1-42/Aβ1-40 and phosphorylated tau/Aβ1-42) perform better than single markers. CSF ratios produce fewer false-negative and false-positive results than individual markers. CSF biomarkers should be included in diagnostic work-up of AD and mild cognitive impairment due to AD.
AB - Biomarker testing is recommended for the accurate and timely diagnosis of Alzheimer's disease (AD). Using illustrative case narratives we consider how cerebrospinal fluid (CSF) biomarker tests may be used in different presentations of cognitive impairment to facilitate timely and differential diagnosis, improving diagnostic accuracy, providing prognostic information, and guiding personalized management in diverse scenarios. Evidence shows that (1) CSF ratios are superior to amyloid beta (Aβ)1-42 alone; (2) concordance of CSF ratios to amyloid positron emission tomography (PET) is better than Aβ1-42 alone; and (3) phosphorylated tau (p-tau)/Aβ1-42 ratio is superior to p-tau alone. CSF biomarkers are recommended for the exclusion of AD as the underlying cause of cognitive impairment, diagnosis of AD at an early stage, differential diagnosis of AD in individuals presenting with other neuropsychiatric symptoms, accurate diagnosis of AD in an atypical presentation, and for clinical trial enrichment. Highlights: Cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarker testing may be underused outside specialist centers. CSF biomarkers improve diagnostic accuracy, guiding personalized management of AD. CSF ratios (amyloid beta [Aβ]1-42/Aβ1-40 and phosphorylated tau/Aβ1-42) perform better than single markers. CSF ratios produce fewer false-negative and false-positive results than individual markers. CSF biomarkers should be included in diagnostic work-up of AD and mild cognitive impairment due to AD.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85131942321&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/35496374
U2 - https://doi.org/10.1002/dad2.12314
DO - https://doi.org/10.1002/dad2.12314
M3 - Review article
C2 - 35496374
SN - 2352-8729
VL - 14
JO - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
JF - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
IS - 1
M1 - e12314
ER -