Cerebrospinal fluid (CSF) biomarkers provide direct molecular insights into central nervous system pathology and are essential for differential diagnosis of neurodegenerative diseases. This page compares key CSF biomarkers across Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), and frontotemporal dementia (FTD)[@blennow2020][@simonsen2022].
Core CSF Biomarker Classes
1. Tau-Related Biomarkers
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Overview
Mermaid diagram (expand to render)
Cerebrospinal fluid (CSF) biomarkers provide direct molecular insights into central nervous system pathology and are essential for differential diagnosis of neurodegenerative diseases. This page compares key CSF biomarkers across Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), and frontotemporal dementia (FTD)[@blennow2020][@simonsen2022].
Core CSF Biomarker Classes
1. Tau-Related Biomarkers
Total Tau (t-Tau)
What it measures: Total tau protein reflecting neuronal injury
AD: Elevated (sensitivity ~80%, specificity ~70%)
PD: Typically normal or mildly elevated
ALS: Elevated in advanced disease
FTD: Variable, often normal in pure FTD
Phosphorylated Tau (p-Tau)
What it measures: Hyperphosphorylated tau indicating NFT pathology
p-Tau181: Most established, AD-specific (sensitivity 85%, specificity 85%)[@hansson2022]
p-Tau217: Highest accuracy for AD (sensitivity 90%, specificity 88%)[@palmqvist2021]
p-Tau231: Earliest detector in preclinical AD[@janelidze2020]
[Blennow K, et al, Cerebrospinal fluid biomarker analysis: recent updates and recommendations for Alzheimer's disease (2020)](https://pubmed.ncbi.nlm.nih.gov/32428553/)
[Simonsen AH, et al, CSF biomarkers in neurodegenerative diseases: clinical utility and approach (2022)](https://pubmed.ncbi.nlm.nih.gov/35872025/)
[Hansson O, et al, CSF biomarkers vs FDG-PET: Agreement and prognostic value in the Swedish BioFINDER study (2022)](https://pubmed.ncbi.nlm.nih.gov/35229096/)
[Palmqvist S, et al, Discriminative accuracy of plasma p-tau217 for Alzheimer disease across the cognitive continuum (2021)](https://pubmed.ncbi.nlm.nih.gov/34554107/)
[Janelidze S, et al, CSF p-tau231 performs better than p-tau181 and p-tau217 in discriminating AD from other neurodegenerative diseases (2020)](https://pubmed.ncbi.nlm.nih.gov/33204670/)
[Schindler SE, et al, Combining cerebrospinal fluid biomarkers with brain amyloid PET for differential diagnosis of dementia (2022)](https://pubmed.ncbi.nlm.nih.gov/35872025/)
[Benatar M, et al, Neurofilament light chain in blood and CSF as a biomarker in ALS (2022)](https://pubmed.ncbi.nlm.nih.gov/35792118/)
[Parnetti L, et al, Cerebrospinal fluid biomarkers in Parkinson's disease: from the limbic system to the brain (2019)](https://pubmed.ncbi.nlm.nih.gov/31740947/)
[Kasai T, et al, TDP-43 in cerebrospinal fluid of patients with ALS and FTLD: a systematic review and meta-analysis (2020)](https://pubmed.ncbi.nlm.nih.gov/31307191/)
[Lista S, et al, Neurogranin in cerebrospinal fluid and blood as a biomarker of synaptic dysfunction (2015)](https://pubmed.ncbi.nlm.nih.gov/25929252/)
[Blennow K, et al, Lecanemab: the beginning of the end of Alzheimer's disease? (2023)](https://pubmed.ncbi.nlm.nih.gov/36689991/)
Pathway Diagram
The following diagram shows the key molecular relationships involving CSF Biomarker Comparison Across Neurodegenerative Diseases discovered through SciDEX knowledge graph analysis: