Home › Research › Getting a diagnosis
CSF markers for incipient Alzheimer's disease
Blennow K, Hampel H.. The Lancet. Neurology, 2003-10-01
Topic: Amyloid, tau and blood-test diagnosis
Early diagnosis of Alzheimer's disease (AD) is needed to initiate symptomatic treatment with acetylcholinesterase inhibitors, and will be of even greater significance if drugs aimed at slowing down the degenerative process, such as vaccination regimes and beta-secretase and gamma-secretase inhibitors, prove to affect AD pathology and to have clinical effect. However, there is no clinical method to determine in which patients mild cognitive impairment (MCI) will progress to AD with dementia, and in which patients MCI is benign. Hence, there is a great clinical need for biomarkers to identify incipient AD in patients with MCI. The CSF biomarkers total tau protein, phosphorylated tau protein, and the 42 amino-acid residue form of amyloid-beta may, if put in the right clinical context, prove to have high enough diagnostic accuracy to meet this challenge.
Key findings
- Early diagnosis of Alzheimer's disease (AD) is needed to initiate symptomatic treatment with acetylcholinesterase inhibitors, and will be of even greater significance if drugs aimed at slowing down the degenerative process, such as vaccination regimes and beta-secretase and gamma-secretase inhibitors, prove to affect AD pathology and to have clinical effect.
- However, there is no clinical method to determine in which patients mild cognitive impairment (MCI) will progress to AD with dementia, and in which patients MCI is benign.
- Hence, there is a great clinical need for biomarkers to identify incipient AD in patients with MCI.
- The CSF biomarkers total tau protein, phosphorylated tau protein, and the 42 amino-acid residue form of amyloid-beta may, if put in the right clinical context, prove to have high enough diagnostic accuracy to meet this challenge.
Why it matters
This 2003 review starts from a clinical problem: doctors had no way to tell which people with mild cognitive impairment would go on to Alzheimer's dementia and which had a "benign" form. It names three spinal-fluid markers (total tau, phosphorylated tau and amyloid-beta 42) that "may, if put in the right clinical context," prove accurate enough to spot early Alzheimer's in these patients. It is a review with no new data and reports no accuracy figures, so it describes a promising approach rather than a proven test.
New to this subject? Start with our plain-English guide: Getting a diagnosis →
Study details
- Evidence strengthLow
How this study scored 57/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (The Lancet. Neurology) |
| Journal's citation record | 3 / 4 | The Lancet Neurology: journal h-index 457 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 1,294 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 51.8 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 5 / 6 | Cited 22.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 5 / 6 | Cited by 127 other studies in this library |
| Still being cited | 3 / 4 | Cited 79 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Harald Juergen Hampel: h-index 136 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Ludwig-Maximilians-Universität München: institution h-index 1,224 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 14505582) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 57 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Blennow, K., & Hampel, H. (2003). CSF markers for incipient Alzheimer's disease. The Lancet. Neurology. https://doi.org/10.1016/s1474-4422(03)00530-1
Vancouver
Blennow K, Hampel H. CSF markers for incipient Alzheimer's disease. The Lancet. Neurology. 2003. doi:10.1016/s1474-4422(03)00530-1. PMID: 14505582.
BibTeX
@article{blennow2003-14505582,
author = {Blennow, K. and Hampel, H.},
title = {{CSF markers for incipient Alzheimer's disease}},
journal = {The Lancet. Neurology},
year = {2003},
doi = {10.1016/s1474-4422(03)00530-1},
pmid = {14505582},
url = {https://doi.org/10.1016/s1474-4422(03)00530-1}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here. Showing 12 of 19.
Later studies that cite this one
127 studies in the alzhub library list this one in their references. Showing the 8 highest-scoring.
Related studies in Getting a diagnosis
Also tagged “biomarkers”
821 studies in the library carry the topic tag “biomarkers”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 821 tagged studies.