Affiliations: [a] Department of Clinical and Behavioural Neurology, Santa Lucia Foundation, Rome, Italy
| [b] Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| [c] Department of Medicine, Center for Memory Disturbances, University of Perugia, Italy
| [d] Department of Experimental Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy
| [e] C. Besta Neurologic Foundation, Milan, Italy
| [f] Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council, Milan, Italy
Correspondence:
[*]
Correspondence to: Giulia M. Sancesario, Department of Clinical and Behavioural Neurology, Santa Lucia
Foundation, Via Ardeatina, 306/354, 00142 Roma, Italy. Tel.: +39 06 20902259; Fax: +39 06 20902349;
giulia.sancesario@gmail.com
Abstract: Although the use of cerebrospinal fluid (CSF) amyloid β1-42 (Aβ42), tau (T-tau), and phosphorylated tau (p-tau181) gives added diagnostic and prognostic values, the diffusion is still limited in clinical practice and only a restricted number of patients receive an integrated clinico-biological diagnosis. By a survey, we aimed to do a “selfie” of the use and diffusion of CSF biomarkers of dementia in Italy, the standardization of pre-analytical procedures, the harmonization of ranges, and the participation to Quality Control programs. An online questionnaire was sent to the members of SIBioC and SINdem-ITALPLANED and to main neurological clinics all over Italy. In Italy, 25 laboratories provide biomarkers analysis in addition to a network of 15 neighboring hospitals. In sum, 40 neurological centers require CSF analyses. 7/20 regions (35%) lack CSF laboratories. Standardization of pre-analytical procedures is present in 62.02% of the laboratories; only 56.00% of the laboratories participate in International Quality Control. There is no harmonization of cut-offs. In Italy, the use of CSF biomarkers is still limited in clinical practice. Standardization and harmonization of normal ranges are needed. To optimize and expand the use of CSF biomarkers, a cost–benefit analysis should be promoted by scientific societies and national health services.
