{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:15:05Z","timestamp":1777396505357,"version":"3.51.4"},"reference-count":87,"publisher":"SAGE Publications","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:p>Background: Discordance among amyloid biomarkers is a challenge to overcome in order to increase diagnostic accuracy in dementia. Objectives: 1) To verify that cerebrospinal fluid (CSF) A\u03b242\/A\u03b240 ratio (A\u03b2R) better agrees with Amyloid PET (Amy-PET) results compared to CSF A\u03b242; 2) to detect differences among concordant positive, concordant negative, and discordant cases, basing the concordance definition on the agreement between CSF A\u03b2R and Amy-PET results; 3) to define the suspected underlying pathology of discordant cases using in vivo biomarkers. Method: We retrospectively enrolled 39 cognitively impaired participants in which neuropsychological tests, apolipoprotein E genotype determination, TC\/MRI, FDG-PET, Amy-PET, and CSF analysis had been performed. In all cases, CSF analysis was repeated using the automated Lumipulse method. In discordant cases, FDG-PET scans were evaluated visually and using automated classifiers. Results: CSF A\u03b2R better agreed with Amy-PET compared to CSF A\u03b242 (Cohen\u2019s K 0.431 versus 0.05). Comparisons among groups did not show any difference in clinical characteristics except for age at symptoms onset that was higher in the 6 discordant cases with abnormal CSF A\u03b2R values and negative Amy-PET (CSF A\u03b2R+\/AmyPET\u2013). FDG-PET and all CSF markers (A\u03b242, A\u03b2R, p-Tau, t-Tau) were suggestive of Alzheimer\u2019s disease (AD) in 5 of these 6 cases. Conclusion: 1) CSF A\u03b2R is the CSF amyloid marker that shows the better level of agreement with Amy-PET results; 2) The use of FDG-PET and CSF-Tau markers in CSFA\u03b2R+\/Amy-PET\u2013discordant cases can support AD diagnosis; 3) Disagreement between positive CSF A\u03b2R and negative Amy-PET in symptomatic aged AD patients could be due to the variability in plaques conformation and a negative Amy-PET scan cannot be always sufficient to rule out AD.<\/jats:p>","DOI":"10.3233\/jad-200119","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T14:29:50Z","timestamp":1595341790000},"page":"203-217","source":"Crossref","is-referenced-by-count":4,"title":["Challenges in Alzheimer\u2019s Disease Diagnostic Work-Up: Amyloid Biomarker Incongruences"],"prefix":"10.1177","volume":"77","author":[{"given":"Gemma","family":"Lombardi","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy"},{"name":"Fondazione Filippo Turati, Pistoia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Pupi","sequence":"additional","affiliation":[{"name":"Fondazione Filippo Turati, Pistoia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Bessi","sequence":"additional","affiliation":[{"name":"Neurology Unit AOU Careggi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Polito","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Experimental and Clinical Sciences \u201cMario Serio\u201d, Nuclear Medicine Unit, University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Padiglioni","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Lucidi","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Don Carlo Gnocchi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Berti","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Experimental and Clinical Sciences \u201cMario Serio\u201d, Nuclear Medicine Unit, University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"De Cristofaro","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, AOU Careggi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Piaceri","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Bagnoli","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedetta","family":"Nacmias","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy"},{"name":"Fondazione IRCCS Don Carlo Gnocchi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandro","family":"Sorbi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, 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