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This CSF profile (A\u03b2\n                      <jats:sup>\u2212<\/jats:sup>\n                      \/pTau181\n                      <jats:sup>+<\/jats:sup>\n                      ) lies outside the AD continuum and complicates real-world etiologic diagnosis of neurocognitive disorders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To determine the prevalence and clinical phenotype associated with the A\u03b2\n                      <jats:sup>\u2212<\/jats:sup>\n                      \/pTau181\n                      <jats:sup>+<\/jats:sup>\n                      CSF biomarker profile in a real-world memory clinic population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We screened the Mount Sinai Hospital database (2015\u20132024) for patients who underwent ADmark CSF biomarker testing. An A\u03b2\n                      <jats:sup>\u2212<\/jats:sup>\n                      \/pTau181\n                      <jats:sup>+<\/jats:sup>\n                      group was classified using assay cutoffs (Amyloid-Total-Tau Index&gt;1.2, pTau181\u2009&gt;\u200954 pg\/mL) and compared to an A\u03b2\n                      <jats:sup>+<\/jats:sup>\n                      group (Amyloid-Total-Tau Index&lt;0.8) matched for pTau181 and total-Tau. Clinical variables were extracted via chart review, limited to notes preceding CSF and blinded to CSF results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The A\u03b2\n                      <jats:sup>\u2212<\/jats:sup>\n                      \/pTau181\n                      <jats:sup>+<\/jats:sup>\n                      group included 25 individuals (10.1% of the cohort) and had equally impaired cognition but fewer episodic memory complaints. Diagnosis was more often Lewy body or frontotemporal dementia. On neuroimaging, A\u03b2\n                      <jats:sup>\u2212<\/jats:sup>\n                      \/pTau181\n                      <jats:sup>+<\/jats:sup>\n                      exhibited less white matter hyperintensity burden and temporoparietal atrophy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      CSF A\u03b2\n                      <jats:sup>\u2212<\/jats:sup>\n                      \/pTau181\n                      <jats:sup>+<\/jats:sup>\n                      is frequent in real-world evaluations of cognitive impairment and presents with fewer AD phenotypic features. Further research is required to clarify A\u03b2\n                      <jats:sup>\u2212<\/jats:sup>\n                      \/pTau181\n                      <jats:sup>+<\/jats:sup>\n                      underlying biology and clinical trajectory.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261445561","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T07:00:29Z","timestamp":1778310029000},"page":"1872-1880","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world clinical profile of individuals with cerebrospinal fluid A\u03b2\n                    <sup>\u2013<\/sup>\n                    \/pTau181\n                    <sup>+<\/sup>"],"prefix":"10.1177","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9964-7888","authenticated-orcid":false,"given":"Ophir","family":"Keret","sequence":"first","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianxu","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Wilkins","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqhwa Nokukhanya Lubimbi","family":"Ncube","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briella","family":"Smaw","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuguang","family":"Xiong","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Gandy","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Pereira","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges","family":"Naasan","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny M.","family":"Elahi","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai"},{"name":"Icahn School of Medicine at Mount Sinai"},{"name":"James J. 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