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

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, Juha O. Rinne, Uroš RotEsen Saka, Hilkka Soininen, Hanne Struyfs, Silvia Suardi, Pieter Jelle Visser, Bengt Winblad, Henrik Zetterberg, Gunhild Waldemar*

*Corresponding author for this work

Research output: Contribution to journalShort surveyAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)285-295
Number of pages11
JournalAlzheimer's and Dementia
Volume13
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

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