CSF biomarkers for the differential diagnosis of Alzheimer's disease: A large‐scale international multicenter study

Abstract

The aim of this study was to test the diagnostic value of cerebrospinal fluid (CSF) beta-amyloid (Aβ_1–42), phosphorylated tau, and total tau (tau) to discriminate Alzheimer's disease (AD) dementia from other forms of dementia. A total of 675 CSF samples collected at eight memory clinics were obtained from healthy controls, AD dementia, subjective memory impairment, mild cognitive impairment, vascular dementia, Lewy body dementia (LBD), fronto-temporal dementia (FTD), depression, or other neurological diseases. CSF Aβ_1–42 showed the best diagnostic accuracy among the CSF biomarkers. At a sensitivity of 85%, the specificity to differentiate AD dementia against other diagnoses ranged from 42% (for LBD, 95% confidence interval or CI = 32–62) to 77% (for FTD, 95% CI = 62–90). CSF Aβ_1–42 discriminates AD dementia from FTD, but shows significant overlap with other non-AD forms of dementia, possibly reflecting the underlying mixed pathologies.