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

Introduction: The aim of this study was to test the diagnostic value of cerebrospinal fluid (CSF) beta-amyloid (A beta(1-42)), phosphorylated tau, and total tau (tau) to discriminate Alzheimer's disease (AD) dementia from other forms of dementia. Methods: 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. Results: CSF A beta(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 5 32-62) to 77% (for FTD, 95% CI 5 62-90). Discussion: CSF A beta 1-42 discriminates AD dementia from FTD, but shows significant overlap with other non-AD forms of dementia, possibly reflecting the underlying mixed pathologies. (C) 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.