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Paraskevas. Neuroimmunol Neuroinflammation 2020;7:183-93 Neuroimmunology
DOI: 10.20517/2347-8659.2019.008 and Neuroinflammation

Review Open Access

Cerebrospinal fluid biomarkers for cognitive
disorders. An introductory overview

George P. Paraskevas

Division of Cognitive and Movement Disorders and Unit of Neurochemistry and Biological Markers, 1st Department of Neurology,
National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, Athens 11528, Greece.
Correspondence to: Dr. George P. Paraskevas, Division of Cognitive and Movement Disorders and Unit of Neurochemistry
and Biological Markers, 1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine,
Eginition Hospital, 72 Vas. Sophias Ave, Athens 11528, Greece. E-mail: geoprskvs44@gmail.com
How to cite this article: Paraskevas GP. Cerebrospinal fluid biomarkers for cognitive disorders. An introductory overview.
Neuroimmunol Neuroinflammation 2020;7:183-93. http://dx.doi.org/10.20517/2347-8659.2019.008
Received: 13 Aug 2019 First Decision: 24 Dec 2019 Revised: 11 Mar 2020 Accepted: 18 Mar 2020 Available online: 24 Jun 2020

Science Editor: George P. Paraskevas Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
The core (established) cerebrospinal fluid biomarkers of Alzheimer’s disease (AD), namely amyloid-beta
peptide, total tau protein and phospho-tau protein, have become a part of the diagnostic workup of patients with
cognitive disorders in many specialized centers, especially for ambiguous cases. Combined, these biomarkers can
identify the presence or absence of an AD biochemical process with sensitivities and specificities approaching or
exceeding 90% in both dementia and pre-dementia stages of AD. Thus, they have been incorporated in various
sets of research or clinical diagnostic criteria and recommendations. Results that are atypical, incompatible with
AD, or inconclusive may occur, necessitating the use of other cerebrospinal fluid or imaging biomarkers.

Keywords: Cerebrospinal fluid, tau, phospho-tau, amyloid-beta, Alzheimer’s disease, alpha-synuclein, TDP-43,
neurofilament light protein

INTRODUCTION
Almost 25 years after their first introduction, cerebrospinal fluid (CSF) biomarkers have become a part
of the diagnostic workup of patients with cognitive disorders in many specialized centers. Furthermore,
they provide neurochemical information about the disorder underlying each individual patient’s clinical
presentation, which currently should be viewed as a biological process, sometimes starting many years
prior to symptom onset and gradually evolving into a typical or atypical clinical phenotype. This paper
provides an introductory, concise review, regarding the current status and future perspectives of CSF
biomarker use.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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