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• W2896749487 abstract "The cerebrospinal fluid (CSF) Aβ42/Aβ40 ratio has been proposed a better biomarker for cerebral β-amyloidosis than CSF Aβ42 alone. Since 2014, the test has been available in our clinical laboratory practice upon request. Here, we evaluated the distribution of the CSF Aβ42/Aβ40 ratio, as well as its diagnostic accuracy in relation amyloid PET. The CSF Aβ42/Aβ40 ratio was measured on a weekly basis in clinical laboratory practice on consecutive samples from 3647 patients (1853 men, 1794 women, mean age ± standard deviation, 71.5 ± 8.2 years) over 3 years using the MSD Abeta Triplex assay according the manufacturer's instructions (Meso Scale Discovery, Rockville, MD). Longitudinal stability in the measurements was maintained using an elaborate QC system. One thousand nineteen of the patients were from the specialized memory clinic at Skåne University Hospital. One hundred and forty three of these had undergone amyloid ([18]F-flutemetamol) PET. Optimal cut-points to discriminate bimodally distributed groups were determined by mixture modelling. The optimal cut-point for differentiating Aβ-positive from -negative patients according to amyloid PET was determined as the one that generated the highest Youden index. The CSF Aβ42/Aβ40 ratio (all data) showed a bimodal normal distribution. The mixture modelling-derived optimal cut-point for differentiating the two groups was 0.076. More patients (56%) were found in the low (Aβ-positive) group. When examining patients from the specialized memory clinic separately, a similar bimodal distribution was seen; the optimal cut-point for distinguishing the two groups was 0.080 and 49% of the patients had ratios below this limit. In patients who had undergone amyloid PET, the optimal mixture modelling-derived cut-point was 0.077, which was a little lower than the Youden index-derived cut-point (0.083) that best discriminated Aβ-positive from -negative cases (diagnostic accuracy 97%). The CSF Aβ42/Aβ40 ratio is a bimodal biomarker. The striking lack of individuals with grey zone CSF Aβ42/Aβ40 ratios suggests that people change Aβ status according to the ratio quite rapidly. It is not a gradual increase of Aβ plaque pathology over years that slowly changes the ratio; rather, the ratio appears to reflect a switch-like shift in Aβ homeostasis in the CSF." @default.
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• W2896749487 date "2018-07-01" @default.
• W2896749487 modified "2023-10-16" @default.
• W2896749487 title "P1‐279: BIMODAL DISTRIBUTION OF THE CSF Aβ42/Aβ40 RATIO IN CLINICAL LABORATORY PRACTICE" @default.
• W2896749487 doi "https://doi.org/10.1016/j.jalz.2018.06.285" @default.
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