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Table 1 CSF biomarkers to distinguish cases with ADD from cases with non-ADD

From: Advantages and disadvantages of the use of the CSF Amyloid β (Aβ) 42/40 ratio in the diagnosis of Alzheimer’s Disease

Study

Number of AD patients

Number of non-AD patients

Number of control patients

CSF biomarkers

Optimal cut-off*

Sensitivity % (95% CI)**

Specificity % (95% CI)**

AUC (95% CI)

SL (p value)#

Shoji et al. [12]

55

68

34

42

158.6 fmol/mL

42/40 ratio##

0.078##

51

82

NP

Lewczuk et al. [13]

22

11

35

42

550 pg/mL

100

80

0.923

42/40 ratio

9.75

95.2

88.4

0.944

NP

Spies et al. [22]

69

69

47

AD vs controls

 

16 DLB

 

42

93

87

0.949

 

27 FTD

 

42/40 ratio

93

87

0.947

NP

 

26 VaD

 

AD vs non-AD

   

42

83

74

0.811

NP

42/40 ratio

85

85

0.903

 

Hertze et al. [32]

94

166 (MCI)

29 (DD)

38

AD vs controls

 

42 MSD

< 523

73

89

0.88 (0.82–0.93)

42 MSD/40 ratio

< 0.069

93

86

0.91 (0.86–0.95)

NP

42 MSD/38 ratio

< 0.37

87

82

0.89 (0.83–0.93)

NP

MCI-AD vs MCI

42 MSD

< 523

67

71

0.73 (0.66–0.80)

42 MSD/40 ratio

< 0.069

85

71

0.86 (0.79–0.91)

NP

42 MSD/38 ratio

< 0.37

88

71

0.85 (0.79–0.91)

NP

Gabelle et al. [14]

52

34

42

AD vs FTD

42

> 464

79

62

0.75

42/40 ratio

≤11.1

79

76

0.85

n.s.

42/38 ratio

≤2.00

88

86

0.87

n.s.

Slaets et al. [16]

80

69 (NP)

11 (AD+CVD)

75

24 DLB (15 NP)

29 FTD (12 NP)

22 VaD (11 NP)

30

42

517 pg/mL

81

59

0.747 (0.670–0.827)

42/40 ratio

0.057

81

60

0.749 (0.673–0.826)

NP

Nutu et al. [17]

48

127

43 PD

33 PDD

       

51 DLB

107

AD vs control

42

444 ng/L

94

72

0.871 (0.811–0.930)

-NP

42/40 ratio

0.125

92

79

0.871 (0.801–0.933)

 

AD vs PDD

42

449 ng/L

94

61

0.805 (0.704–0.905)

42/40 ratio

0.150

90

81

0.910 (0.844–0.976)

NP

AD vs DLB

42

387 ng/L

88

41

0.675 (0.570–0.780)

42/40 ratio

0.115

90

57

0.759 (0.664–0.853)

NP

Baldeiras et al. [18]

   

AD vs controls

42

534 pg/mL

82

74

0.818

40/42 ratio

8.3

59

81

0.719

NP

AD vs FTD

     

42

538 pg/mL

70

82

0.791

40/42 ratio

5.4

59

87

0.778

NP

Dumurgier et al. [19]

367 (AD+ non-AD)

0

AD vs non-AD

42

737–836 pg/mL

78

79

0.81

42/40 ratio

0.050–0.082

73

78

0.81

NP

Struyfs et al. [23]

100

50

50

AD vs controls

50 (AD)

17 (DLB)

 

42

< 722 pg/mL

98.0

74.0

0.874

50 (MCI-AD)

17 (FTD)

 

42/40 ratio

< 0.1099

85.7

78.0

0.881

NP

 

16 (VaD)

 

42/38 ratio

< 0.269

81.6

82.0

0.858

NP

   

AD vs non-AD

42

< 694 pg/mL

95.9

40.0

0.686

42/40 ratio

< 0.1215

93.9

50.0

0.782

NP

42/38 ratio

< 0.2730

81.6

68.0

0.804

NP

Bousiges et al. [25]

70

55

15

Pro-AD vs pro-DLB

31 (AD-d)

20 (DLB-d)

 

42

≤ 730 ng/L

84.6

71.4

0.84 (0.74–0.92)

39 (pro-AD)

35 (pro-DLB)

 

42/40 ratio

≤ 0.0529

88.9

100

0.95 (0.83–0.99)

NP

   

AD-d vs DLB-d

42

≤ 504 ng/L

67.7

80

0.77 (0.63–0.88)

42/40 ratio

≤ 0.0799

92.3

88.9

0.86 (0.64–0.97)

NP

Janelidze et al. [24]

Cohort 2

Cohort 2

Cohort 2

AD vs MCI

75 (AD)

62 (MCI)

53

42

0.817 (0.743–0.890)

35 (MCI-AD)

34 (VaD)

Cohort 3

42/40 ratio

0.879 (0.823–0.936)

< 0.028

Cohort 3

47 (DLB/PDD)

328

42/38 ratio

0.856 (0.790–0.923)

< 0.222

137

33 (FTD)

 

AD vs DLB/PDD

 

Cohort 3

 

42

0.583 (0.476–0.690)

 

35 (DLB/PDD)

 

42/40 ratio

0.792 (0.707–0.877)

< 0.001

 

128 (PD)

 

42/38 ratio

0.796 (0.710–0.883)

< 0.001

   

AD vs VaD

42

0.698 (0.580–0.816)

42/40 ratio

0.880 (0.814–0.946)

< 0.001

42/38 ratio

0.860 (0.786–0.935)

< 0.001

AD vs non-AD

 

42

0.720 (0.651–0.788)

42/40 ratio

0.863 (0.813–0.912)

< 0.001

42/38 ratio

0.863 (0.813–0.913)

< 0.001

Lehmann et al. [26]

342

562

0

AD vs non-AD

Cohort 1

Cohort 1

 

Cohort 1

 

124

276

 

42

500 pg/mL

0.78 (0.734–0.818)

Cohort 2

Cohort 2

 

42/40 ratio

0.1

0.90 (0.865–0.926)

< 0.0001

218

286

 

Cohort 2

 

42

700 pg/mL

0.60 (0.553–0.641)

42/40 ratio

0.05

0.77 (0.728–0.803)

< 0.0001

  1. *Optimal cut-offs were created using different statistical approaches—please see original articles for details. **Sensitivity and specificity are a function of the cut-off, and the cut-offs were calculated in different ways; therefore, they are not clearly comparable across different articles. #Significance levels (p values) of the AUC values are comparisons of the Aβ isoform ratios vs Aβ42 alone. ##Note that the ratio in the original article is inversed, but for consistency, the Aβ42/40 ratio has been calculated for this table. Amyloid beta, AD Alzheimer’s Disease, ADD AD dementia, Ad-d demented AD patients, AUC area under curve, CJD Creutzfeldt-Jakob Disease, CSF cerebrospinal fluid, DLB dementia with Lewy bodies, DLB-d demented DLB patients, FTD frontotemporal dementia, MCI mild cognitive impairment, MCI-AD MCI that subsequently developed ADD or MCI due to AD, NP neuropathologically confirmed, NP not provided, NPH normal pressure hydrocephalus, n.s not significant, PD Parkinson’s Disease, PDD Parkinson’s Disease dementia, pro-AD prodromal-AD patients, pro-DLB prodromal-DLB patients, PsD psychiatric disorders, SL significance level, VaD vascular dementia