Cerebrospinal Fluid Biomarkers for the Diagnosis of Alzheimer Disease in South Korea

Park, Sun Ah MD, PhD; Chae, Won Seok MD, PhD; Kim, Hyeong Jun MD; Shin, Ho Sik MD; Kim, Saeromi MD; Im, Ji Young MS; Ahn, Sang Il MS; Min, Kyoung Dae MD, PhD; Yim, Soo Jae MD, PhD; Ye, Byoung Seok MD, PhD; Seo, Sang Won MD, PhD; Jeong, Jee Hyang MD, PhD; Park, Kyung Won MD, PhD; Choi, Seong Hye MD, PhD; Na, Duk L. MD, PhD

Alzheimer Disease & Associated Disorders:
doi: 10.1097/WAD.0000000000000184
Original Articles

Laboratory-specific reference values for cerebrospinal fluid (CSF) Alzheimer disease (AD) biomarkers are necessary. Our objective was to apply well-known CSF biomarkers and redetermine their diagnostic cutoff values for AD in South Korea. CSF samples from matched control subjects (n=71), patients with AD dementia (ADD, n=76), and other neurological disorders with cognitive decline (OND, n=47) were obtained from 6 Korean dementia clinics according to a standardized protocol. CSF biomarker concentrations were measured using enzyme-linked immunosorbent assay. CSF biomarkers differed significantly between the ADD and control groups (P<0.001 for all), and between the ADD and OND groups (P<0.001 for all). The areas under the curve in differentiation of ADD from control subjects were 0.97 for Aβ42, 0.93 for total tau (tTau), 0.86 for pTau, and 0.99 for both tTau/Aβ42 and pTau/Aβ42 ratios. Our revised cutoff value for Aβ42 was higher than our previous one, whereas the values for the Tau proteins were similar. The tTau/Aβ42 ratio had the highest accuracy, 97%. Our findings highlight the usefulness of CSF AD biomarkers in South Korea, and the necessity of continually testing the reliability of cutoff values.

Author Information

Departments of *Neurology

Anesthesiology and Pain Medicine

Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon

§Department of Neurology, Yonsei University College of Medicine

Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine

Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul

#Department of Neurology, College of Medicine, Institute of Convergence Bio-Health, Dong-A University, Busan

**Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea

S.A.P. and W.S.C. are co-first authors.

Supported by Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI14C1942).

The authors declare no conflicts of interest.

Reprints: Sun Ah Park, MD, PhD, Departments of Neurology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Republic of Korea, 14584 (e-mail: sapark@schmc.ac.kr; sapark001@gmail.com).

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/

Received June 2, 2016

Accepted November 26, 2016

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