title: The Clinical Use of Cerebrospinal Fluid Biomarkers for Alzheimer's Disease Diagnosis: The Italian Selfie.
abstract: Although the use of cerebrospinal fluid (CSF) amyloid β1-42 (Aβ42), tau (T-tau), and phosphorylated tau (p-tau181) gives added diagnostic and prognostic values, the diffusion is still limited in clinical practice and only a restricted number of patients receive an integrated clinico-biological diagnosis. By a survey, we aimed to do a "selfie" of the use and diffusion of CSF biomarkers of dementia in Italy, the standardization of pre-analytical procedures, the harmonization of ranges, and the participation to Quality Control programs. An online questionnaire was sent to the members of SIBioC and SINdem-ITALPLANED and to main neurological clinics all over Italy. In Italy, 25 laboratories provide biomarkers analysis in addition to a network of 15 neighboring hospitals. In sum, 40 neurological centers require CSF analyses. 7/20 regions (35%) lack CSF laboratories. Standardization of pre-analytical procedures is present in 62.02% of the laboratories; only 56.00% of the laboratories participate in International Quality Control. There is no harmonization of cut-offs. In Italy, the use of CSF biomarkers is still limited in clinical practice. Standardization and harmonization of normal ranges are needed. To optimize and expand the use of CSF biomarkers, a cost-benefit analysis should be promoted by scientific societies and national health services.
authors.affiliation: Department of Clinical and Behavioural Neurology, Santa Lucia Foundation, Rome, Italy.
authors.forename: Giulia M
authors.initials: GM
authors.lastname: Sancesario
authors.affiliation: Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Sofia
authors.initials: S
authors.lastname: Toniolo
authors.affiliation: Department of Medicine, Center for Memory Disturbances, University of Perugia, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Chiasserini
authors.affiliation: Department of Clinical and Behavioural Neurology, Santa Lucia Foundation, Rome, Italy.|Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Simona G
authors.initials: SG
authors.lastname: Di Santo
authors.affiliation: Department of Experimental Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Josh
authors.initials: J
authors.lastname: Zegeer
authors.affiliation: C. Besta Neurologic Foundation, Milan, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Bernardi
authors.affiliation: Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Musicco
authors.affiliation: Department of Clinical and Behavioural Neurology, Santa Lucia Foundation, Rome, Italy.|Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Caltagirone
authors.affiliation: Department of Medicine, Center for Memory Disturbances, University of Perugia, Italy.
authors.forename: Lucilla
authors.initials: L
authors.lastname: Parnetti
authors.affiliation: Department of Experimental Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bernardini
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000453:epidemiology; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D010446:Peptide Fragments / Q000134:cerebrospinal fluid*; D010766:Phosphorylation; D011795:Surveys and Questionnaires; D051844:alpha-Synuclein / Q000134:cerebrospinal fluid; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: D016229:Amyloid beta-Peptides; D010446:Peptide Fragments; D051844:alpha-Synuclein; C075222:amyloid beta-protein (1-42); D016875:tau Proteins
keywords: Alzheimer’s disease diagnosis; cerebrospinal fluid; neurodegenerative biomarkers; survey