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Alzheimer’s Disease and Other Neurodegenerative Disorders

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Cerebrospinal Fluid in Clinical Neurology

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Abstract

Traditionally, patients suffering from Alzheimer’s disease (AD) have been diagnosed according to clinical criteria, and a diagnosis has only been made in the dementia stage of the disease. Definite diagnosis required autopsy to confirm the neuropathological findings associated with AD, namely, extracellular depositions of amyloid β (Aβ) protein and intraneuronal neurofibrillary tangles consisting of hyperphosphorylated tau (P-tau) protein, together with gross cortical atrophy caused by neuronal degeneration and loss. These findings are reflected in the cerebrospinal fluid (CSF) of patients with AD. Numerous studies have shown that AD patients have lower levels of Aβ42 and higher levels of P-tau and total tau (T-tau) in CSF than cognitively healthy controls. In the new diagnostic criteria for AD, these CSF biomarkers are included as in vivo evidence of AD neuropathology together with positron emission tomography (PET) measurements of global cortical amyloid load. Further, AD is now divided into several disease stages, namely, preclinical AD and mild cognitive impairment and dementia due to AD. In this chapter, we review CSF biomarker characteristics for the various disease stages for AD and how to use them in the differentiation against other common neurodegenerative disorders. New candidate CSF biomarkers for AD are also presented, as well as a discussion on the standardization of biomarkers and their application in clinical trials.

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Authors and Affiliations

  1. Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden

    Christoffer Rosén, Henrik Zetterberg & Kaj Blennow

  2. UCL Institute of Neurology, Department of Molecular Neuroscience, Queen Square, London, WC1N 3BG, UK

    Henrik Zetterberg

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  1. Christoffer Rosén
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  2. Henrik Zetterberg
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  3. Kaj Blennow
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Correspondence to Christoffer Rosén .

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Editors and Affiliations

  1. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

    Florian Deisenhammer

  2. Department of Neurology, Danish Multiple Sclerosis Center Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Finn Sellebjerg

  3. Department of Clinical Chemistry, VU University Medical Center Amsterdam Neurochemistry Laboratory and Biobank, Amsterdam, The Netherlands

    Charlotte E Teunissen

  4. Department of Neurology, University of Ulm, Ulm, Germany

    Hayrettin Tumani

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Rosén, C., Zetterberg, H., Blennow, K. (2015). Alzheimer’s Disease and Other Neurodegenerative Disorders. In: Deisenhammer, F., Sellebjerg, F., Teunissen, C., Tumani, H. (eds) Cerebrospinal Fluid in Clinical Neurology. Springer, Cham. https://doi.org/10.1007/978-3-319-01225-4_20

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