“The CSF findings should be viewed as an important adjunct to the diagnostic algorithm and complement the recommended practice of obtaining a careful history, conducting a comprehensive examination, completing the neuropsychological testing, and performing brain imaging,” they stated. “Measurements of CSF beta-amyloid and tau protein levels are not perfect biomarkers for Alzheimer’s disease, but they fulfill almost all of the desirable features outlined by the [Working Group on Molecular and Biochemical Markers of Alzheimer’s Disease] in 1998.… The scientific evidence accumulated during the past decade indicates that CSF analyses do provide important information that should be part of a clinical diagnosis and care.”
According to Drs. Herskovits and Growdon, the next step in implementing CSF biomarkers into the diagnosis of Alzheimer’s disease is to educate patients that the test is both safe and useful and to overcome existing bias. “For patients, the procedure is often perceived as painful, difficult to perform, and dangerous,” they noted.
It could be helpful to replace such “threatening” terms as spinal tap and lumbar puncture with the more neutral “spinal fluid collection” and follow it with a “full explanation of the procedure,” they concluded.
—Rebecca Abma