Cited by 1,291Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsCerebrospinal fluid and hydrocephalus

CSF markers for incipient Alzheimer's disease

Blennow, Kaj, Hampel, Harald·2003·The Lancet Neurology

Abstract

Early diagnosis of Alzheimer's disease (AD) is needed to initiate symptomatic treatment with acetylcholinesterase inhibitors, and will be of even greater significance if drugs aimed at slowing down the degenerative process, such as vaccination regimes and beta-secretase and gamma-secretase inhibitors, prove to affect AD pathology and to have clinical effect. However, there is no clinical method to determine in which patients mild cognitive impairment (MCI) will progress to AD with dementia, and in which patients MCI is benign. Hence, there is a great clinical need for biomarkers to identify incipient AD in patients with MCI. The CSF biomarkers total tau protein, phosphorylated tau protein, and the 42 amino-acid residue form of amyloid-beta may, if put in the right clinical context, prove to have high enough diagnostic accuracy to meet this challenge.

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Crossref · 10.1016/s1474-4422(03)00530-1

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88 of 88 references verified0 citation errors · 0 not checkable

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  • CSF biomarkers are measures of the concentrations of proteins in CSF from the lumbar sac that reflect the rates of both production and clearance at a given point in time.

    “CSF biomarkers are measures of the concentrations of proteins in CSF from the lumbar sac that reflect the rates of both production (protein expression or release/secretion from neurons or other brain cells) and clearance (degradation or removal) at a given point in time [114,115].”
  • CSF T-tau reflects the intensity of neuronal damage at a specific point.

    “Taken together, these data indicate that CSF T-tau reflects the intensity of neuronal damage at a specific point [114], whereas elevated CSF P-tau reflects an abnormal pathologic state associated with PHF tau formation.”
  • CSF T-tau likely indicates the intensity of neuronal injury at a given point in time.

    “CSF T-tau likely indicates the intensity of neuronal injury at a given point in time [108,114,157,158].”
  • CSF p-tau, regardless of phosphorylation site, has been considered as a biomarker of NFT pathology, while other studies propose CSF p-tau as a state marker for brain tau phosphorylation, yet the direct association between CSF p-tau and tau PET has been inconsistent.

    “CSF p-tau, regardless of phosphorylation site, has been considered as a biomarker of NFT pathology, while other studies propose CSF p-tau as a state marker for brain tau phosphorylation,62 yet the direct association between CSF p-tau and tau PET has been inconsistent.”
  • Changes in CSF P-tau217 and P-tau181 indicate "disease state," i.e., the presence of a pathological process associated with AD from very early on in the disease, while the continuous increase in Tau PET makes Tau PET a marker of "disease stage" throughout the symptomatic phases of AD.

    “changes in CSF P-tau217 and P-tau181 would indicate “disease state,” i.e., the presence of a pathological process associated with AD from very early on in the disease, while the continuous increase in Tau PET [and the strong correlations between Tau PET and atrophy and cognitive decline; (39)] would make Tau PET a marker of “disease stage” throughout the symptomatic phases of AD.”

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Authors
Blennow, K., & Hampel, H.
Affiliations
  • University of Gothenburg (SE)
  • Ludwig-Maximilians-Universität München (DE)
Corresponding author
Blennow, Kaj
Venue
The Lancet Neurology
Publisher
Elsevier BV
Published
2003-10
Volume
2
Issue
10
Pages
605-613
ISSN
1474-4422 (ISSN-L)
OpenAlex
W2108475007
Cited by
1,291
References
88
Citations by year
2026: 16 · 2025: 21 · 2024: 44 · 2023: 33 · 2022: 49 · 2021: 57 · 2020: 54 · 2019: 49 · 2018: 57 · 2017: 59 · 2016: 54 · 2015: 59 · 2014: 73 · 2013: 66 · 2012: 66
FWCI
5.96
Type
journal article
Language
en
Open access
closed
Locations
  • The Lancet Neurology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
Keywords
Alzheimer's disease, cerebrospinal fluid biomarkers, early diagnosis, mild cognitive impairment, tau protein, phosphorylated tau, amyloid-beta 42, conversion to dementia
MeSH terms
Alzheimer Disease, Cholinesterase Inhibitors, Humans, Peptide Fragments, Sensitivity and Specificity, Biomarkers, Amyloid beta-Peptides, MEDLINE, tau Proteins

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