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The following is a summary of “Lumipulse-Measured Cerebrospinal Fluid Biomarkers for the Early Detection of Alzheimer Disease,” published in the November 2024 issue of Neurology by Safransky et al.    

Cerebrospinal fluid (CSF) biomarkers, including amyloid-beta 42 (Aβ42) and phosphorylated tau (p-tau181), assist in detecting Alzheimer’s disease (AD) pathology during life.  

Researchers conducted a retrospective study investigating the association between CSF biomarkers and AD neuropathologic changes (ADNC).  

They analyzed brain donors from the National Alzheimer’s Coordinating Center (NACC) who had normal cognition at the time of lumbar puncture (LP) and underwent measurements of CSF Aβ42 and p-tau181 using Lumipulse assays (n=49). The participants were classified into “AD−” (no AD/low ADNC) and “AD+” (intermediate/high ADNC). The accuracy of each biomarker for discriminating AD status was assessed using the area under the curve (AUC) statistics generated from binary logistic regressions that accounted for age, sex, APOE ε4, and the interval between LP and death.  

The results showed that the average age at LP was 79.3 years (SD = 5.6), and the average age at death was 87.1 years (SD = 6.5). Of the 49 brain donors, 20 (40.8%) had autopsy-confirmed AD. The average interval from LP to death was 7.76 years (SD = 4.31). The CSF p-tau181/Aβ42 was the optimal predictor of AD, demonstrating excellent discrimination accuracy (AUC = 0.97, 95% CI 0.94–1.00, P=0.003), CSF p-tau181 alone had the second-best discrimination accuracy (AUC = 0.92, 95% CI 0.84–1.00, P=0.001), followed by CSF Aβ42 alone (AUC = 0.92, 95% CI 0.85–1.00, P=0.007), while CSF total tau (t-tau) had the numerically lowest discrimination accuracy (AUC = 0.87, 95% CI 0.76–0.97, P=0.005).  

They concluded that lumipulse-measured CSF Aβ42 and p-tau181, especially the p-tau181/Aβ42 ratio, were adequate for the early detection of AD pathophysiology.  

Source: neurology.org/doi/10.1212/WNL.0000000000209866