CSF Tau and Amyloid Biomarkers in Cognitive Impairment Across the ALS-FTD Spectrum: A Systematic Narrative Review and Evidence Map.

What was studied

This narrative review looked at tau and amyloid in spinal fluid (CSF). It covered the ALS-FTD spectrum. ALS is amyotrophic lateral sclerosis. FTD is frontotemporal dementia. The authors asked how these markers relate to thinking and memory. They searched PubMed, Scopus and Google Scholar through May 2026, plus Web of Science. They found a few observational studies with 638 participants.

What they found

Total tau and p-tau181 had the most steady links with cognition. Total tau tracked with the ECAS total score, at r = -0.398. It also tracked with ALS-specific cognition, at -0.403. Higher p-tau181 went with lower ECAS and poorer memory. Lower Aβ42/Aβ40 went with poorer memory. This amyloid link was not consistently replicated across cohorts. Differences between studies ruled out a meta-analysis.

What it means for patients

The authors say total tau may reflect broader nerve injury. They say p-tau181 and Aβ42/Aβ40 may say more about some cognitive types. They may also point to Alzheimer co-pathology. They say these markers should remain research tools.

Why it is not certain yet

The evidence is limited and varies a lot. Only a few studies were found. Larger, standardized, long-term studies are needed. The studies were observational, so links do not prove cause.

Source

CSF Tau and Amyloid Biomarkers in Cognitive Impairment Across the ALS-FTD Spectrum: A Systematic Narrative Review and Evidence Map.

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