Title:Neurodegeneration and Glial Activation Related CSF Biomarker as the Diagnosis
of Alzheimer’s Disease: A Systematic Review and an Updated Meta-
analysis
Volume: 19
Issue: 1
Author(s): Yuehan Hao, Xu Liu and Ruixia Zhu*
Affiliation:
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
Keywords:
CSF biomarker, neuron-specific enolase, VLP-1, neurogranin, YKL-40, Alzheimer's disease
Abstract: Objective: Recently, neuron specific enolase (NSE), Visinin-like protein-1 (VLP-1), neurogranin
(Ng), and YKL-40 have been identified as candidates for neuronal degeneration and glial
activation biomarkers. Therefore, we perform a comprehensive meta-analysis to assess the diagnostic
value of CSF NSE, VLP-1, Ng and YKL-40 in Alzheimer’s disease (AD).
Methods: We searched Pubmed, MEDLINE, EMBASE databases for research about the levels of
CSF NSE, VLP-1, Ng and YKL-40 in AD patients compared with controls or other dementia diseases
until Dec 2020.
Results: The present meta-analysis contained a total of 51 studies comprising 6248 patients with
dementia disorders and 3861 controls. Among them, there were 3262 patients with AD, 2456 patients
with mild cognitive impairment (MCI), 173 patients with vascular dementia (VaD), 221 patients
with frontotemporal dementia (FTD), and 136 with Lewy bodies dementia (DLB). Our study
demonstrated that CSF NSE, VLP-1, Ng and YKL-40 levels were increased in AD as compared to
healthy controls. We also observed that the CSF NSE level was higher in AD than VaD, suggesting
CSF NSE might act as a key role in distinguishing between AD and VaD. Interestingly, there
was a higher VLP-1 expression in AD, and a lower expression in DLB patients. Moreover, we
found the CSF Ng level was increased in AD than MCI, implying CSF Ng might be a biomarker
for identifying the progression of AD. Additionally, a significantly higher CSF YKL-40 level was
detected not only in AD, but also in FTD, DLB, VaD, signifying YKL-40 was not sensitive in the
diagnosis of AD.
Conclusion: Our study confirmed that CSF levels of NSE, VLP-1, and Ng could be valuable biomarkers
for identifying patients who are more susceptible to AD and distinguishing AD from other
neurodegenerative dementia disorders.
