# Profiles of blood–brain barrier and neurodegeneration markers in cerebrospinal fluid of patients with cerebral amyloid angiopathy

## TL;DR

This study examines cerebrospinal fluid markers in patients with cerebral amyloid angiopathy to understand differences between those with and without hemorrhagic markers.

## Contribution

The study identifies specific cerebrospinal fluid and blood-brain barrier markers associated with hemorrhagic markers in cerebral amyloid angiopathy.

## Key findings

- Lower CSF Aβ42 and Aβ40 are linked to hemorrhagic markers in CAA patients.
- Higher blood-brain barrier permeability is associated with hemorrhagic markers in CAA.
- Increased CAA imaging burden correlates with higher total tau protein in CSF.

## Abstract

There are few studies analyzing cerebrospinal fluid (CSF) in patients with cerebral amyloid angiopathy (CAA). Our goal was to compare blood–brain barrier and neurodegeneration markers in CSF in CAA patients with and without hemorrhagic markers.

In a retrospective study of patients with CAA (Boston criteria version 2.0) identified from the Aachen Memory Database and from in‐hospital admission records, we compared CSF neurodegeneration markers and albumin ratio (a blood–brain barrier permeability marker) in patients with and without hemorrhagic markers.

Among 371 patients with CAA, 113 patients had hemorrhagic markers (30.5%). Lower amyloid beta (Aβ) 42, lower Aβ40, and higher albumin ratio were independently associated with the presence of hemorrhagic markers and an increasing number of lobar microbleeds. Cortical superficial siderosis and a higher imaging burden of CAA were associated with total tau protein.

Presence of hemorrhagic markers in CAA patients is associated with lower CSF Aβ42 and Aβ40 and higher blood–brain barrier permeability.

New diagnostic criteria allow for the diagnosis of CAA without hemorrhagic markers.CAA hemorrhagic markers are associated with lower Aβ42 and Aβ40 in CSF.CAA hemorrhagic markers are associated with higher blood–brain barrier permeability.Higher imaging burden of CAA is associated with higher total tau protein in CSF.

New diagnostic criteria allow for the diagnosis of CAA without hemorrhagic markers.

CAA hemorrhagic markers are associated with lower Aβ42 and Aβ40 in CSF.

CAA hemorrhagic markers are associated with higher blood–brain barrier permeability.

Higher imaging burden of CAA is associated with higher total tau protein in CSF.