Neurology Central

Cerebrospinal fluid biomarkers in neurodegenerative disorders

Neurodegenerative diseases represent a daunting challenge in clinical diagnosis and management. Biomarkers that might aid in the diagnosis of these devastating and globally important diseases are urgently sought and required. Here we describe the application and state of development of a range of cerebrospinal fluid biomarkers in common neurodegenerative disorders including Alzheimer’s disease, frontotemporal dementia and prion diseases.
Alzheimer’s disease

Cerebrospinal fluid (CSF) biomarkers and their use in neurodegenerative disorders represent an emerging area of research. The clinical use of CSF biomarkers for Alzheimer’s disease (AD) is better supported than for other neurodegenerative diseases. CSF biomarkers are useful as screening tools and as supplementary information to diagnostic investigations but are lacking as diagnostic tools in isolation.

For AD, established markers are T-tau, P-tau and Aβ42 [1]. CSF Aβ42 is elevated, while CSF T-tau and P-tau are lowered [2]. Their significance results from their direct correspondence to the AD amyloid/tau hypothesis and evidence of effective clinical use. Of the markers discussed here, T-tau, P-tau and Aβ42 are some of few to actually form part of diagnostic criteria; this triplet of biomarkers is part of both the International Working Group IWG-2 Criteria for AD and the National Institute on Aging-Alzheimer’s Association (NIA-AA) Criteria for AD and mild cognitive impairment (MCI) resulting from AD [3]. In both criteria, CSF T-tau, P-tau and Aβ42 are part of the same criterion as amyloid imaging, in allowance for dissociation between CSF biomarkers and imaging studies [3,4].

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