Alzheimer's disease normative cerebrospinal fluid biomarkers validated in pet amyloid-β characterized subjects from the Australian imaging, biomarkers and lifestyle (AIBL) study

Qiao Xin Li, Victor L. Villemagne, James D. Doecke, Alan Rembach, Shannon Sarros, Shiji Varghese, Amelia McGlade, Katrina M. Laughton, Kelly K. Pertile, Christopher J. Fowler, Rebecca L. Rumble, Brett O. Trounson, Kevin Taddei, Stephanie R. Rainey-Smith, Simon M. Laws, Joanne S. Robertson, Lisbeth A. Evered, Brendan Silbert, Kathryn A. Ellis, Christopher C. Rowe & 6 others S. Lance Macaulay, David Darby, Ralph N. Martins, David Ames, Colin L. Masters, Steven Collins*

*Corresponding author for this work

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: The cerebrospinal fluid (CSF) amyloid-β (Aβ)1-42, total-tau (T-tau), and phosphorylated-tau (P-tau181P) profile has been established as a valuable biomarker for Alzheimer's disease (AD). Objective: The current study aimed to determine CSF biomarker cut-points using positron emission tomography (PET) Aβ imaging screened subjects from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study of aging, as well as correlate CSF analyte cut-points across a range of PET Aβ amyloid ligands. Methods: Aβ pathology was determined by PET imaging, utilizing 11C-Pittsburgh Compound B, 18F-flutemetamol, or 18Fflorbetapir, in 157 AIBL participants who also underwent CSF collection. Using anINNOTEST assay, cut-points were established (Aβ 1-42 >544 ng/L, T-tau <407 ng/L, and P-tau181P <78 ng/L) employing a rank based method to define a positive CSF in the sub-cohort of amyloid-PET negative healthy participants (n = 97), and compared with the presence of PET demonstrated AD pathology. Results: CSF Aβ 1-42 was the strongest individual biomarker, detecting cognitively impaired PET positive mild cognitive impairment (MCI)/AD with 85% sensitivity and 91% specificity. The ratio of P-tau181P or T-tau to Aβ1-42 provided greater accuracy, predicting MCI/AD with Aβ pathology with ?92% sensitivity and specificity. Cross-validated accuracy, using all three biomarkers or the ratio of P-tau or T-tau to Aβ 1-42 to predict MCI/AD, reached ?92% sensitivity and specificity. Conclusions: CSF Aβ1-42 levels and analyte combination ratios demonstrated very high correlation with PET Aβ imaging. Our study offers additional support for CSF biomarkers in the early and accurate detection of AD pathology, including enrichment of patient cohorts for treatment trials even at the pre-symptomatic stage.

Original languageEnglish
Pages (from-to)175-187
Number of pages13
JournalJournal of Alzheimer's Disease
Volume48
Issue number1
DOIs
Publication statusPublished - 28 Aug 2015
Externally publishedYes

Keywords

  • Alzheimer's disease
  • Amyloid-β
  • Cerebrospinal fluid biomarkers
  • Positron emission tomography Aβ imaging
  • Tau

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