Recommendations for cerebrospinal fluid Alzheimer's disease biomarkers in the diagnostic evaluation of mild cognitive impairment |
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| Authors: | Sanna-Kaisa Herukka Anja Hviid Simonsen Niels Andreasen Ines Baldeiras Maria Bjerke Kaj Blennow Sebastiaan Engelborghs Giovanni B Frisoni Tomasz Gabryelewicz Samantha Galluzzi Ron Handels Milica G Kramberger Agnieszka Kulczyńska Jose Luis Molinuevo Barbara Mroczko Agneta Nordberg Catarina Resende Oliveira Markus Otto Gunhild Waldemar |
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| Institution: | 1. Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland;2. Danish Dementia Research Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark;3. Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden;4. Neurochemistry Laboratory, Faculty of Medicine, CHUC—Coimbra University Hospital, CNC, CNC.IBILI—Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal;5. Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium;6. Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden;7. Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium;8. Geneva Neuroscience Center, University Hospitals and University of Geneva, Geneva, Switzerland;9. IRCCS Fatebenefratelli, Brescia, Italy;10. Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland;11. Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands;12. Center for Cognitive Impairments, Department of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia;13. Department of Neurodegeneration Diagnostics, Medical University of Bia?ystok, Bia?ystok, Poland;14. Alzheimer''s Disease and Other Cognitive Disorders Unit, Hospital Clinic i Universitari, IDIBAPS, Barcelona, Spain;15. Beta Brain Research Center, Fundació Pasqual Maragall, Barcelona, Spain;p. Department of Biochemical Diagnostics, University Hospital in Bia?ystok, Bia?ystok, Poland;q. Department of NVS, Center for Alzheimer Research, Translational Alzheimer Neurobiology, Karolinska Institutet, Huddinge, Sweden;r. Department of Neurology, University of Ulm, Ulm, Germany;s. Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland;t. Department of Neurology, Hacettepe University Hospitals, Ankara, Turkey;u. Neuropathology Laboratory, Neurological Institute C. Besta, Milan, Italy;v. Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands;w. Department of Neurology, Alzheimer Centre, VUMC, Amsterdam, The Netherlands;x. Department NVS, Karolinska Institutet, Center for Alzheimer Research, Division of Neurogeriatrics, Huddinge, Sweden;y. Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK |
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| Abstract: | This article presents recommendations, based on the Grading of Recommendations, Assessment, Development, and Evaluation method, for the clinical application of cerebrospinal fluid (CSF) amyloid-β1–42, tau, and phosphorylated tau in the diagnostic evaluation of patients with mild cognitive impairment (MCI). The recommendations were developed by a multidisciplinary working group and based on the available evidence and consensus from focused group discussions for 1) prediction of clinical progression to Alzheimer's disease (AD) dementia, 2) cost-effectiveness, 3) interpretation of results, and 4) patient counseling. The working group recommended using CSF AD biomarkers in the diagnostic workup of MCI patients, after prebiomarker counseling, as an add-on to clinical evaluation to predict functional decline or conversion to AD dementia and to guide disease management. Because of insufficient evidence, it was uncertain whether CSF AD biomarkers outperform imaging biomarkers. Furthermore, the working group provided recommendations for interpretation of ambiguous CSF biomarker results and for pre- and post-biomarker counseling. |
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| Keywords: | Alzheimer's disease Biomarkers CSF Diagnostics GRADE Mild cognitive impairment Recommendations |
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