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Table 5 AUC (and 95% CI) and specificity (at a fixed sensitivity of 85%) of the ‘top 5’ biomarkers, comparing AD with other neurodegenerative disorders and controls

From: Cerebrospinal fluid in the differential diagnosis of Alzheimer’s disease: clinical utility of an extended panel of biomarkers in a specialist cognitive clinic

Diagnostic groups

Biomarker

AUC (95% CI)

Specificity (%)*

AD vs HC

AβX-42/X-40 ratio

0.95 (0.92–0.99)

93%

Aβ1–42 (pg/mL)

0.93 (0.88–0.98)

90%

T-tau/Aβ1–42 ratio

0.93 (0.89–0.97)

83%

T-tau (pg/mL)

0.81 (0.73–0.90)

53%

P-tau (pg/L)

0.80 (0.71–0.88)

54%

All the above

0.91 (0.84–0.95)

88%

AD vs DLB

P-tau (pg/L)

0.79 (0.68–0.90)

50%

T-tau (pg/mL)

0.78 (0.67–0.88)

50%

T-tau/Aβ1–42 ratio

0.77 (0.66–0.88)

40%

AβX-42/X-40 ratio

0.73 (0.59–0.88)

47%

APPβ (ng/mL)

0.73 (0.58–0.87)

44%

All the above

0.75 (0.54–0.88)

50%

AD vs bvFTD

T-tau/Aβ1–42 ratio

0.89 (0.85–0.94)

70%

AβX-42/X-40 ratio

0.86 (0.77–0.94)

85%

T-tau (pg/mL)

0.83 (0.76–0.90)

64%

Aβ1–42 (pg/mL)

0.78 (0.70–0.87)

60%

P-tau (pg/L)

0.78 (0.70–0.86)

46%

All the above

0.86 (0.78–0.92)

81%

AD vs PNFAa

NFL (ng/L)

0.84 (0.76–0.93)

50%

T-tau/Aβ1–42 ratio

0.67 (0.54–0.80)

24%

Aβ1–42 (pg/mL)

0.65 (0.50–0.80)

35%

All the above

0.60 (0.16–0.76)

42%

AD vs SDb

AβX-42/X-40 ratio

0.92 (0.86–0.97)

100%

T-tau/Aβ1–42 ratio

0.91 (0.86–0.96)

86%

Aβ1–42 (pg/mL)

0.91 (0.84–0.98)

86%

NFL (ng/L)

0.87 (0.78–0.96)

67%

P-tau (pg/L)

0.85 (0.75–0.94)

29%

AD vs non-AD dementia

T-tau/Aβ1–42 ratio

0.82 (0.77–0.88)

56%

AβX-42/X-40 ratio

0.79 (0.72–0.87)

68%

T-tau (pg/mL)

0.77 (0.71–0.83)

51%

P-tau (pg/L)

0.76 (0.70–0.83)

41%

Aβ1–42 (pg/mL)

0.73 (0.67–0.80)

48%

All the above

0.81 (0.73–0.85)

68%

AD vs all others (including HC)

T-tau/Aβ1–42 ratio

0.85 (0.80–0.90)

63%

AβX-42/X-40 ratio

0.84 (0.79–0.90)

76%

T-tau (pg/mL)

0.78 (0.73–0.84)

51%

Aβ1–42 (pg/mL)

0.78 (0.73–0.84)

59%

P-tau (pg/L)

0.77 (0.71–0.83)

45%

All the above

0.84 (0.79–0.90)

75%

  1. amyloid beta, AD Alzheimer’s disease, APP amyloid precursor protein, AUC area under the curve, bvFTD behavioural variant frontotemporal dementia, CI confidence interval, DLB dementia with Lewy bodies, HC healthy controls, PNFA progressive non-fluent aphasia, SD Semantic dementia, NFL neurofilament light chain, P-tau phosphorylated tau, T-tau total tau
  2. aOnly three biomarkers were found to be significant, see Table 3
  3. bThere is no joint model for AD vs SD because n < 10 for SD