Relationship between different cerebrospinal fluid biomarkers in multiple sclerosis: meaning and use in clinical practice

Author(s):  
Bonaventura Casanova Estruch
2020 ◽  
Vol 45 ◽  
pp. 102391 ◽  
Author(s):  
Mie Reith Mahler ◽  
Helle Bach Søndergaard ◽  
Sophie Buhelt ◽  
Marina Rode von Essen ◽  
Jeppe Romme Christensen ◽  
...  

2010 ◽  
Vol 2 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Diane Slats ◽  
Petra E. Spies ◽  
Magnus J.C. Sjögren ◽  
Frans R.J. Verhey ◽  
Marcel M. Verbeek ◽  
...  

2017 ◽  
Vol 15 (1) ◽  
pp. 100-104 ◽  
Author(s):  
Renan Barros Domingues ◽  
Gustavo Bruniera Peres Fernandes ◽  
Fernando Brunale Vilela de Moura Leite ◽  
Charles Peter Tilbery ◽  
Rodrigo Barbosa Thomaz ◽  
...  

ABSTRACT The cerebrospinal fluid analysis has been employed for supporting multiple sclerosis diagnosis and ruling out the differential diagnoses. The most classical findings reflect the inflammatory nature of the disease, including mild pleocytosis, mild protein increase, intrathecal synthesis of immunoglobulin G, and, most typically, the presence of oligoclonal bands. In recent years, new biomarkers have emerged in the context of multiple sclerosis. The search for new biomarkers reflect the need of a better evaluation of disease activity, disease progression, and treatment efficiency. A more refined evaluation of disease and therapy status can contribute to better therapeutic choices, particularly in escalation of therapies. This is very relevant taking into account the availability of a greater number of drugs for multiple sclerosis treatment in recent years. In this review, we critically evaluate the current literature regarding the most important cerebrospinal fluid biomarkers in multiple sclerosis. The determination of biomarkers levels, such as chemokine ligand 13, fetuin A, and mainly light neurofilament has shown promising results in the evaluation of this disease, providing information that along with clinical and neuroimaging data may contribute to better therapeutic decisions.


2020 ◽  
Vol 17 (8) ◽  
pp. 698-708
Author(s):  
Ismael Carrera-Muñoz ◽  
Lucía Triguero-Cueva ◽  
Juan C. Romero-Fábrega ◽  
Eva M. Triviño-Ibáñez ◽  
Rosa Vilchez-Carrillo ◽  
...  

Introduction: In the absence of a gold standard for in vivo Alzheimer disease (AD) diagnosis, AD biomarkers such as cerebrospinal fluid biomarkers (CSF-B) and PET-Amyloid are considered diagnostically useful in clinical practice guidelines and have consensual appropriate use criteria (AUC). However, little evidence has been published on their utilization in the clinical setting or on approaches to mismatched results. The objective of this work was to evaluate the use of AD biomarkers in clinical practice, focusing on the implementation of PET-Amyloid in cases of inconclusive CSF-B. Methods: This naturalistic, ambispective case series included patients fulfilling AUC for CSF-B and PET-Amyloid whose CSF-B results were non-diagnostic (target population), analyzing the diagnostic certainty, the treatment approach, and the relationship between CSF-B and PET-Amyloid results. Results: Out of 2373 eligible patients, AD biomarkers were studied in 417 (17.6%), most frequently due to cognitive impairment in under 65-year-olds, using CSF-B in 311 patients and PET-Amyloid in 150. CSF-B results were non-diagnostic for 44 patients (52.3% male; aged 60.9±6.6 years), who then underwent PET-Amyloid study, which was positive in 31. A ‘k’ coefficient of 0.108 was obtained between CSF-B and PET-amyloid (54.5% concordance). In multivariate regression analysis, Aβ42 was the only significant predictor (p= 0.018) of a positive PET-Amyloid result. In the target population, PETAmyloid increased diagnostic confidence by 53.7% (p <0.001) and modified the therapeutic approach in 36.4% of cases. Conclusion: These findings support the duplication of AD biomarkers and demonstrate that the implementation of PET-Amyloid provides an early and certain diagnosis to guide appropriate treatment.


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