Fluid biomarkers for cerebral amyloid angiopathy

Joji B. Kuramatsu, MD, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany, discusses biomarkers for cerebral amyloid angiopathy (CAA). CAA is defined by the deposition of amyloid beta (Aβ) in the cerebrovasculature and thus, a definite diagnosis can only be made by histopathology. The Boston criteria was introduced to allow a diagnosis of probable CAA in living patients with no available brain tissue. Clinical data and imaging demonstrating lobar hemorrhage with cerebral microbleeds or cortical superficial siderosis, in the absence of other diagnostic lesions or causes of hemorrhage, can be used to diagnose probable CAA. Dr Kuramatsu comments on other surrogate markers, including enlarged perivascular spaces, lacunes, and microinfarcts, and the promise of liquid biomarkers. Combining all available information and defining relevant biomarkers in the blood and cerebrospinal fluid of patients with CAA would aid diagnosis and treatment. This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.