Clinical application of CSF biomarkers for Alzheimer's disease: From rationale to ratios.
Clinical application of CSF biomarkers for Alzheimer's disease: From rationale to ratios.
复制标题
DOI：
10.1002/dad2.12314
复制
发表时间：
2022
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
生物标志物检测被推荐用于准确和及时诊断阿尔茨海默病（AD）。使用说明性病例叙述，我们考虑如何脑脊液（CSF）生物标志物检测可用于不同的认知功能障碍的表现，以促进及时和鉴别诊断，提高诊断准确性，提供预后信息，并在不同的情况下指导个性化管理。有证据表明：（1）CSF比值上级优于β淀粉样蛋白（Aβ）1 - 42单独给药;（2）CSF比值与淀粉样蛋白正电子发射断层扫描（PET）的一致性优于Aβ1 - 42单独给药;（3）磷酸化tau（p-tau）/Aβ1 - 42比值上级优于p-tau单独给药。建议使用CSF生物标志物排除AD作为认知障碍的潜在原因，在早期诊断AD，在表现出其他神经精神症状的个体中鉴别诊断AD，在非典型表现中准确诊断AD，并用于临床试验富集。脑脊液（CSF）阿尔茨海默病（AD）生物标志物检测可能在专科中心之外未得到充分利用。CSF生物标志物提高诊断准确性，指导AD的个性化管理。CSF比值（淀粉样β [Aβ]1 - 42/Aβ1 - 40和磷酸化tau/Aβ1 - 42）优于单一标志物。CSF比值产生的假阴性和假阳性结果比单个标志物少。CSF生物标志物应包括在AD和AD所致轻度认知功能障碍的诊断检查中。
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. 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.