Current advances in plasma and cerebrospinal fluid biomarkers in Alzheimer's disease

Purpose of review This review provides a concise overview of recent advances in cerebrospinal fluid (CSF) and blood-based biomarkers of Alzheimer's disease lesions. Recent findings Important recent advances for CSF Alzheimer's disease biomarkers include the introduction of fully automated assays, the development and implementation of certified reference materials for CSF A beta 42 and a unified protocol for handling of samples, which all support reliability and availability of CSF Alzheimer's disease biomarkers. A beta deposition can be detected using A beta 42/A beta 40 ratio in both CSF and plasma, though a much more modest change is seen in plasma. Tau aggregation can be detected using phosphorylated tau (P-tau) at threonine 181 and 217 in CSF, with similar accuracy in plasma. Neurofilament light (NfL) be measured in CSF and shows similar diagnostic accuracy in plasma. Though total tau (T-tau) can also be measured in plasma, this measure is of limited clinical relevance for Alzheimer's disease in its current immunoassay format. Alzheimer's disease biomarkers, including A beta, P-tau and NfL can now be reliably measured in both CSF and blood. Plasma-based measures of P-tau show particular promise, with potential applications in both clinical practice and in clinical trials.

Automated summary

Recent advances in CSF and blood-based biomarkers of Alzheimer's disease lesions include the introduction of fully automated assays, certified reference materials for CSF A beta 42, and a unified protocol for sample handling. These developments support the reliability and availability of biomarkers, such as A beta, P-tau, and NfL, in both CSF and blood, with potential applications in clinical practice and trials.