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Front. Aging Neurosci., 24 March 2014 | http://dx.doi.org/10.3389/fnagi.2014.00047

Meta-review of CSF core biomarkers in Alzheimer’s disease: the state-of-the-art after the new revised diagnostic criteria

  • 1Section of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
  • 2Evaluation Unit of the Canary Islands Health Service, Santa Cruz de Tenerife, Spain
  • 3Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Santa Cruz de Tenerife, Spain
  • 4Agency for Health Technology Assessment, Institute of Health Carlos III, Madrid, Spain

Background: Current research criteria for Alzheimer’s disease (AD) include cerebrospinal fluid (CSF) biomarkers into the diagnostic algorithm. However, spreading their use to the clinical routine is still questionable.

Objective: To provide an updated, systematic and critical review on the diagnostic utility of the CSF core biomarkers for AD.

Data sources: MEDLINE, PreMedline, EMBASE, PsycInfo, CINAHL, Cochrane Library, and CRD.

Eligibility criteria: (1a) Systematic reviews with meta-analysis; (1b) Primary studies published after the new revised diagnostic criteria; (2) Evaluation of the diagnostic performance of at least one CSF core biomarker.

Results: The diagnostic performance of CSF biomarkers is generally satisfactory. They are optimal for discriminating AD patients from healthy controls. Their combination may also be suitable for mild cognitive impairment (MCI) prognosis. However, CSF biomarkers fail to distinguish AD from other forms of dementia.

Limitations: (1) Use of clinical diagnosis as standard instead of pathological postmortem confirmation; (2) variability of methodological aspects; (3) insufficiently long follow-up periods in MCI studies; and (4) lower diagnostic accuracy in primary care compared with memory clinics.

Conclusion: Additional work needs to be done to validate the application of CSF core biomarkers as they are proposed in the new revised diagnostic criteria. The use of CSF core biomarkers in clinical routine is more likely if these limitations are overcome. Early diagnosis is going to be of utmost importance when effective pharmacological treatment will be available and the CSF core biomarkers can also be implemented in clinical trials for drug development.

Keywords: Alzheimer’s disease, cerebrospinal fluid biomarkers, amyloid beta-protein (42), tau protein, sensitivity, specificity, meta-review, state-of-the-art review

Citation: Ferreira D, Perestelo-Pérez L, Westman E, Wahlund L-O, Sarría A and Serrano-Aguilar P (2014) Meta-review of CSF core biomarkers in Alzheimer’s disease: the state-of-the-art after the new revised diagnostic criteria. Front. Aging Neurosci. 6:47. doi: 10.3389/fnagi.2014.00047

Received: 12 December 2013; Paper pending published: 16 February 2014;
Accepted: 02 March 2014; Published online: 24 March 2014.

Edited by:

Elena Galea, Universitat Autònoma de Barcelona, Spain

Reviewed by:

Diego Ruano, University of Seville, Spain
Agneta Nordberg, Karolinska Institutet, Sweden

Copyright: © 2014 Ferreira, Perestelo-Pérez, Westman, Wahlund, Sarría and Serrano-Aguilar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Lilisbeth Perestelo-Pérez, Servicio de Evaluación del Servicio Canario de la Salud, Camino Candelaria, s/n, El Rosario, Santa Cruz de Tenerife 38109, Spain e-mail: lperperr@gobiernodecanarias.org, lilisbethp@gmail.com