Journal List > Dement Neurocogn Disord > v.12(1) > 1120809

Dement Neurocogn Disord. 2013 Mar;12(1):1-8. Korean.
Published online Mar 31, 2013.
© 2013 Korean Dementia Association
Preliminary Study for a Multicenter Study of Alzheimer's Disease Cerebrospinal Fluid Biomarkers
Sun Ah Park, M.D.,* Jung Hun Kim, M.D., Hyeong Jun Kim, M.D.,* Tae Eun Kim, M.D.,* Yoon-Jeong Kim, M.S.,* Dong Hyun Lee, M.D.,* Jeong Ho Park, M.D.,* Won Seok Chae, M.D., Soo Jae Yim, M.D.,§ Sang Won Seo, M.D., Duk L. Na, M.D., and Seong Hye Choi, M.D.
*Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Department of Neurology, Ilsan Hospital, National Health Insurance Corporation, Goyang, Korea.
Department of Anesthesiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
§Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Department of Neurology, Inha University School of Medicine, Incheon, Korea.

Address for correspondence: Seong Hye Choi, M.D. Department of Neurology, Inha University School of Medicine, 366 Seohae-daero, Jung-gu, Incheon 400-103, Korea. Tel: +82-32-890-3659, Fax: +82-32-890-3864, Email:
Received Aug 13, 2012; Revised Feb 12, 2013; Accepted Feb 12, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



The usefulness of cerebrospinal fluid (CSF) concentrations of amyloid beta protein 1-42 (Aβ42), phosphorylated tau (pTau) and total tau (tTau) have been increasing in Alzheimer's disease (AD). However, the direct adoption of previously reported standard values is not appropriate due to interlaboratory variability. We started this study to set up an accessible system to measure CSF biomarkers in our country with high reproducibility and validity.


Including CSFs from four different institutes the levels of Aβ42, pTau181 and tTau were measured in one lab. The intertest variability and difference in the levels of biomarkers depending on diseases were assessed. Through analysis of receiver operating characteristic cut points and binary logistic regression the cut-off values of Aβ42, pTau and tTau level were obtained, and their validity was evaluated.


The intertest consistency was high in measuring CSF biomarkers. The value of Aβ42 was markedly decreased in AD (n= 17) and other dementia (n= 9) compared to normal control (n= 12). The levels of pTau181 and tTau were high in AD, but not in other dementia and normal control. The threshold values of Aβ42, pTau181 and tTau were 290.3 pg/mL, 54.3 pg/mL, and 320.7 pg/mL in differentiating AD from normal control showing high sensitivity and specificity. Especially, the ratios of pTau181/Aβ42 (> 0.16) and tTau/Aβ42 (> 0.76) showed the prime validity.


Our data of CSF Aβ42, pTau181, and tTau levels were highly reproducible. PTau181/Aβ42 and tTau/Aβ42 ratios were the greatly helpful in differentiating AD from normal control.

Keywords: Alzheimer's disease; Amyloid beta protein; Biomarker; Enzyme-linked immunosorbent assay; Cerebrospinal fluid; Tau


Table 1
Demographic characteristics of the subjects (mean±SD)
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Table 2
The coefficient of variance percent (CV%) within a test and intertest correlations
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Table 3
The concentrations of Aβ42, pTau181, tTau in cerebrospinal fluid
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Table 4
Receiver operating characteristic (ROC) curve parameters
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Table 5
Brief summary of the previous literatures
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