Alzheimer's disease CSF biomarkers: clinical indications and rational use

Ellis Niemantsverdriet, Sara Valckx, Maria Bjerke, Sebastiaan Engelborghs, Ellis Niemantsverdriet, Sara Valckx, Maria Bjerke, Sebastiaan Engelborghs

Abstract

This review focusses on the validation and standardization of Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers, as well as on the current clinical indications and rational use of CSF biomarkers in daily clinical practice. The validated AD CSF biomarkers, Aβ1-42, T-tau, and P-tau181, have an added value in the (differential) diagnosis of AD and related disorders, including mixed pathologies, atypical presentations, and in case of ambiguous clinical dementia diagnosis. CSF biomarkers should not be routinely used in the diagnostic work-up of dementia and cannot be used to diagnose non-AD dementias. In cognitively healthy subjects, CSF biomarkers can only be applied for research purposes, e.g., to identify pre-clinical AD in the context of clinical trials with potentially disease-modifying drugs. Therefore, biomarker-based early diagnosis of AD offers great opportunities for preventive treatment development in the near future.

Keywords: Alzheimer’s disease; Amyloid-β; Biomarkers; Cerebrospinal fluid; Dementia; Tau.

Conflict of interest statement

Conflict of interest

This research was in part funded by the EU/EFPIA Innovative Medicines Initiative Joint Undertaking (EMIF Grant No. 115372); the University Research Fund of the University of Antwerp; the Flemish Impulse Financing of Networks for Dementia Research (VIND); and unrestrictive research grants from Janssen Pharmaceutica NV and ADx Neurosciences. Sebastiaan Engelborghs has received unrestricted research grants from Janssen Pharmaceutica NV and ADx Neurosciences (paid to institution). Ellis Niemantsverdriet, Sara Valckx, and Maria Bjerke report no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

None.

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Source: PubMed

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