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Discrepancies between CSF biomarker and PET determinations of elevated brain amyloid and their prognostic significance

  • 0Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Alzheimer's & Dementia : the Journal of the Alzheimer's Association +

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July 9, 2025

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July 9, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Individuals with mild cognitive impairment (MCI) showing discordant amyloid-beta (Aβ) results between cerebrospinal fluid (CSF) and PET scans have a benign prognosis. These discordant amyloid patterns in MCI do not predict clinical decline over 4 years.

Area Of Science

  • Neurodegenerative disease research
  • Biomarker analysis in Alzheimer's disease

Background

  • Cerebrospinal fluid (CSF) and positron emission tomography (PET) are used to detect amyloid-beta-peptide (Aβ) pathology.
  • Discordant results between CSF and PET for Aβ pathology create uncertainty in therapeutic decision-making for neurodegenerative diseases.

Purpose Of The Study

  • To investigate the clinical outcomes of mild cognitive impairment (MCI) patients with discordant amyloid-beta (Aβ) status determined by CSF and PET.
  • To assess the prognostic value of discordant Aβ biomarkers in MCI.

Main Methods

  • Analysis of baseline characteristics and longitudinal outcomes in 541 MCI patients from the Alzheimer's Disease Neuroimaging Initiative.
  • Grouping patients based on concurrent CSF and PET Aβ measurements (normal/abnormal) using standard cutpoints.

Main Results

  • Approximately 5% of MCI patients showed discordant Aβ status (CSF+/PET- or CSF-/PET+).
  • Neither discordant group exhibited significant decline in memory or Clinical Dementia Rating Sum of Boxes scores over 4 years.
  • The CSF+/PET+ group showed significant worsening in both measures.

Conclusions

  • Discordant amyloid biomarkers (CSF+/PET- or CSF-/PET+) in MCI are uncommon and associated with a benign prognosis.
  • MCI patients with discordant amyloid biomarkers do not show clinical decline, unlike those with concordantly positive Aβ markers.
  • CSF-PET discordant individuals with MCI tend to have less abnormal baseline values and a favorable 4-year outlook.

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