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Published January 1, 2017 | Version v1
Journal article Open

Recommendations for cerebrospinal fluid Alzheimer's disease biomarkers in the diagnostic evaluation of mild cognitive impairment

Creators

  • 1. Rigshosp, Copenhagen Univ Hosp, Danish Dementia Res Ctr, Copenhagen, Denmark
  • 2. Karolinska Univ Hosp, Dept Geriatr Med, Huddinge, Sweden
  • 3. Univ Coimbra, CHUC Coimbra Univ Hosp, CNC IBILI Ctr Neurosci & Cell Biol, Neurochem Lab,Fac Med,CNC, Coimbra, Portugal
  • 4. Univ Antwerp, Inst Born Bunge, Reference Ctr Biol Markers Dementia BIODEM, Antwerp, Belgium
  • 5. Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Psychiat & Neurochem, Molndal, Sweden
  • 6. Polish Acad Sci, Mossakowski Med Res Ctr, Dept Neurodegenerat Disorders, Warsaw, Poland
  • 7. IRCCS Fatebenefratelli, Brescia, Italy
  • 8. Maastricht Univ, Sch Mental Hlth & Neurosci, Alzheimer Ctr Limburg, Maastricht, Netherlands
  • 9. Univ Med Ctr Ljubljana, Dept Neurol, Ctr Cognit Impairments, Ljubljana, Slovenia
  • 10. Med Univ Bialystok, Dept Neurodegenerat Diagnost, Bialystok, Poland
  • 11. Karolinska Inst, Dept NVS, Ctr Alzheimer Res, Translat Alzheimer Neurobiol, Huddinge, Sweden
  • 12. Univ Ulm, Dept Neurol, Ulm, Germany

Description

This article presents recommendations, based on the Grading of Recommendations, Assessment, Development, and Evaluation method, for the clinical application of cerebrospinal fluid (CSF) amyloid-beta(1-42), 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. (C) 2016 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.

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