This study aims to investigate whether the heart fatty acid-binding protein (HFABP) in the cerebrospinal fluid (CSF) was a potential predictive biomarker for Alzheimer’s disease (AD).

We evaluated the associations of CSF HFABP levels with core biomarkers, cognition, and brain structure in a sample population (n = 302) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. Multiple linear regression and mixed-effects models were employed in the analyses. AD progression was assessed using the Kaplan–Meier survival analysis.

CSF HFABP was higher in patients with mild cognitive impairment and AD than the normal controls (p < 0.001) and was particularly higher in those with amyloid-β (Aβ) pathologic features. CSF HFABP was associated with higher baseline CSF t-tau (p < 0.001), CSF p-tau (p < 0.001), and CSF t-tau/Aβ₄₂ and CSF p-tau/Aβ₄₂ (p < 0.01). Moreover, CSF HFABP was found to play predictive roles in hippocampal atrophy (p < 0.01), cognitive decline (p < 0.05), and the risk of AD (p < 0.001).

Our findings suggest that CSF HFABP can be a predictive biomarker of AD.

To examine whether plasma neurofilament light (NFL) might be a potential longitudinal biomarker for Alzheimer’s disease (AD).

A total of 835 individuals from the Alzheimer’s Disease Neuroimaging Initiative were involved. Correlations of the rate of change in plasma NFL with cerebrospinal fluid biomarkers, cognition, and brain structure were investigated. Cox proportional hazards models were used to assess the associations between quartiles of plasma NFL and the risk of AD conversion.

Participants were further divided into β amyloid-positive (Aβ+) versus β amyloid-negative (Aβ−), resulting in five biomarker group combinations, which are CN Aβ−, CN Aβ+, MCI Aβ−, MCI Aβ+ and AD Aβ+. Plasma NFL concentration markedly increased in the five groups longitudinally (p < 0.001) with the greatest rate of change in AD Aβ+ group. The rate of change in plasma NFL was associated with cognitive deficits and neuroimaging hallmarks of AD over time (p < 0.005). Compared with the bottom quartile, the top quartile of change rate was associated with a 5.41-fold increased risk of AD (95% CI = 1.83−16.01) in the multivariate model.

Our finding implies the potential of plasma NFL as a longitudinal noninvasive biomarker in AD.