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CSF from individuals with DS showed elevated proNGF, neuroserpin, MMP\u20103, and MMP\u20109. ProNGF and MMP\u20109 in CSF differentiated DSAD from aDS (area under the curve\u00a0=\u00a00.86, 0.87). NGF pathway markers associated with CSF amyloid beta and tau and differed by sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Brain NGF metabolism changes can be monitored in plasma and CSF, supporting relevance in AD pathology. 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