Correct in vivo diagnosis of Alzheimer’s disease (AD) helps to avoid administration of disease-modifying treatments in non-AD patients, and allows the possible use of such treatments in clinically atypical AD patients. Cerebrospinal fluid (CSF) biomarkers offer a tool for AD diagnosis. A reduction in CSF β-amyloid (marker of amyloid plaque burden), although compatible with Alzheimer’s pathological change, may also be observed in other dementing disorders, including vascular cognitive disorders due to subcortical small-vessel disease, dementia with Lewy bodies and normal-pressure hydrocephalus. Thus, for the diagnosis of AD, an abnormal result of CSF β-amyloid may not be sufficient, and an increase in phospho-tau (marker of tangle pathology) is also required in order to confirm AD diagnosis in patients with a typical amnestic presentation and reveal underlying AD in patients with atypical or mixed and diagnostically confusing clinical presentations.

中文翻译：

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疾病修饰治疗时代阿尔茨海默病的脑脊液生物标志物

阿尔茨海默病 (AD) 的正确体内诊断有助于避免对非 AD 患者进行疾病缓解治疗，并允许在临床非典型 AD 患者中使用此类治疗。脑脊液 (CSF) 生物标志物为 AD 诊断提供了一种工具。CSF β-淀粉样蛋白（淀粉样蛋白斑块负荷的标志物）的减少，虽然与阿尔茨海默病的病理变化相一致，但也可能在其他痴呆症中观察到，包括皮层下小血管疾病引起的血管性认知障碍、路易体痴呆和正常-压力性脑积水。因此，对于 AD 的诊断，CSF β-淀粉样蛋白的异常结果可能是不够的，