Role of CSF biomarkers in the diagnosis of prodromal Alzheimer's disease

Alzheimer's disease (AD) core biomarkers (A beta(1-42), total tau and phosphorylated tau) have proven to be useful in the clinical practice to evaluate patients with mild cognitive impairment in order to predict progression to Alzheimer's disease. Multicenter studies have shown an good overall performance of A beta(1-42), total tau and phosphorylated tau in the diagnosis of early AD; however, they also evidenced some possible weakness in terms of variability among centers, which generates some concern about their use in routine clinical practice. Therefore, the need for a joint effort of academia, companies and government agencies is evident. In this article we will provide the state of art of AD biomarkers application for the diagnosis of early AD, also describing some of the most promising new putative biomarkers currently studied. The final aim is to introduce a panel of AD biomarkers that is able to describe the preclinical phases of AD, as fully as possible paving the way to a routine early diagnosis in view of treatment by means of disease-modifying drugs.