Cognitive Impairment Center, Local Health Authority n. 2 Marca Trevigiana, Treviso, Italy.
Associazione Alzheimer Treviso Onlus, Treviso, Italy.
J Alzheimers Dis. 2022;86(3):1061-1072. doi: 10.3233/JAD-215432.
The most significant biomarkers that are included in the Alzheimer's disease (AD) research framework are amyloid-β plaques deposition, p-tau, t-tau, and neurodegeneration.Although cerebrospinal fluid (CSF) biomarkers are included in the most recent AD research criteria, their use is increasing in the routine clinical practice and is applied also to the preclinical phases of AD, including mild cognitive impairment. The role of these biomarkers is still unclear concerning the preclinical stage of AD diagnosis, the CSF methodology, and the costs-benefits of the biomarkers' tests. The controversies regarding the use of biomarkers in the clinical practice are related to the concepts of analytical validity, clinical validity, and clinical utility and to the question of whether they are able to diagnose AD without the support of AD clinical phenotypes.
The objective of the present work is to expose the strengths and weaknesses of the use of CSF biomarkers in the diagnosis of AD in a clinical context.
We used PubMed as main source for articles published and the final reference list was generated on the basis of relevance to the topics covered in this work.
The use of CSF biomarkers for AD diagnosis is certainly important but its indication in routine clinical practice, especially for prodromal conditions, needs to be regulated and also contextualized considering the variety of possible clinical AD phenotypes.
We suggest that the diagnosis of AD should be understood both as clinical and pathological.
阿尔茨海默病（AD）研究框架中包含的最重要的生物标志物是淀粉样蛋白-β斑块沉积、p-tau、t-tau 和神经退行性变。尽管脑脊液（CSF）生物标志物已包含在最新的 AD 研究标准中，但它们在常规临床实践中的使用正在增加，并也应用于 AD 的临床前阶段，包括轻度认知障碍。这些生物标志物在 AD 诊断的临床前阶段、CSF 方法学以及生物标志物检测的成本效益方面的作用仍不清楚。关于在临床实践中使用生物标志物的争议涉及分析有效性、临床有效性和临床实用性的概念，以及它们是否能够在没有 AD 临床表型支持的情况下诊断 AD 的问题。
本研究的目的是在临床背景下阐述 CSF 生物标志物在 AD 诊断中的优势和劣势。
我们使用 PubMed 作为主要的文章来源，并根据与本工作涵盖的主题的相关性生成最终的参考文献列表。
CSF 生物标志物在 AD 诊断中的应用固然重要，但在常规临床实践中，尤其是在前驱期，其适应症需要加以规范，并结合可能出现的各种 AD 临床表型加以考虑。
我们建议 AD 的诊断应被理解为临床和病理两方面。
