Cerebrospinal Fluid Analysis Should Be Considered in Patients with Cognitive Problems

Table 1

CSF biomarkers of pathological findings in relation to differential diagnoses in memory clinic patients.

Diagnosis	Amyloid pathology (A𝛽1-42)	Tangle pathology (P-tau)	Cortical axonal damage (T-tau)	Sub-cortical axonal damage (NFL)	Blood-brain barrier dysfunction (CSF/serum albumin ratio)	Inflammation (CSF cell counts, IgG or IgM production)
AD	Yes	Yes	Yes	No	No	No
VaD	No	No	Yes	Yes	Yes	No
			(especially in relation to new brain infarcts)
FTD	No	Yes	Yes	Yes	No	No
		(but not in CSF)	(mild)
LBD	Yes	No	Yes	No	No	No
			(mild)
PD	No	No	No	No	No	No
PSP	No	Yes	No	Yes	No	No
		(but not in CSF)
CJD	No	No	Yes	Yes	No	No
			(severe)	(mild to moderate)
Depression	No	No	No	No	No	No
Lyme disease	No	No	No	Yes	Yes	Yes
				(mild)		(especially IgM)
Multiple sclerosis	No	No	No	Yes	No	Yes
					(mild in 10%)	(especially IgG)
Acute stroke	No	No	Yes	Yes	Yes	No
Normal aging	No	No	No	No	No	No

Abbreviations: CSF = cerebrospinal fluid; A𝛽1-42 = the 42 amino acid isoform of amyloid 𝛽; P-tau = hyperphosphorylated tau; T-tau = total tau; NFL = neurofilament light; AD = Alzheimer’s disease; VaD = vascular dementia; FTD = frontotemporal dementia; LBD = Lewy body dementia; PD = Parkinson’s disease; PSP = progressive supranuclear palsy; CJD = Creutzfeldt-Jakob disease.