CSF biomarkers support the diagnosis of AD in nearly 90% of clinical cases

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August 03, 2022

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Aguero P, et al. Alzheimer’s CSF biomarkers in clinical practice. Presented at: Alzheimer’s Association International Conference; July 31-August. 4; San Diego.


Disclosures: Aguero does not report any relevant financial information.


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SAN DIEGO — Cerebrospinal fluid biomarkers have supported the clinical diagnosis of Alzheimer’s disease in a small cohort of patients, according to a poster presentation at the Alzheimer’s Association’s international conference.

“We analyzed the use of biomarkers in our clinical setting… [to check] the accuracy with which these biomarkers serve as a diagnostic tool in the clinical setting of a normal patient with suspected Alzheimer’s disease”, pablo Aguerodoctor, of the University Hospital of the Jiménez Díaz Foundation in Madrid, said.




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Agüero and colleagues analyzed 141 consecutive CSF samples from patients with suspected cognitive decline who were referred to the hospital’s memory clinic and used the Lumipulse G600II chemiluminescent immunoassay (Fujirebio) to determine the ratio of beta- amyloid 42, ratio 42/40, total Tau and phospho-Tau.

The researchers divided the clinical diagnoses into AD, degenerative non-AD and non-degenerative, based on clinical criteria at the patients’ previous visits. They then separated the groups based on biomarkers: negative for AD (A–T–N– and A–T–N+), positive for AD (A+T+N+ and A+T+N–), cases with A+ but T– amyloidosis (A+T–N+; A+T–N–) and cases without A– but T+ amyloidosis (A–T+N+).

According to the results, 50% of the patients had a positive AD result, which coincided with the clinical amnestic AD phenotype or other related phenotypes, while 37% had a negative AD result correlated with non-AD or non-degenerative neurodegenerative diagnoses.

However, the researchers found that 13% of cases had inconsistencies within the biomarkers, particularly with A– (n=7) and A+ (n=11) results. Regarding clinical diagnoses, all patients with A–T+N+ and eight of 11 patients with A+ biomarkers were considered AD phenotypes. In two of the first cases, AD diagnoses were later confirmed by a positive PET-amyloid study and fully positive CSF biomarkers.

“These biomarkers are a really useful diagnostic tool,” Agüero said. “In most cases, almost 90%, they give a very clear answer if the patient has [or doesn’t have] Alzheimer’s disease due to cognitive decline. And in cases where the results aren’t clear, it’s usually Alzheimer’s disease.

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