ORIGINAL ARTICLE The relationship between CSF biomarkers and cerebral metabolism in early-onset Alzheimer’s disease Alice Jaillard 1,2 & Matthieu Vanhoutte 1 & Aurélien Maureille 3 & Susanna Schraen 4 & Emilie Skrobala 3 & Xavier Delbeuck 3 & Adeline Rollin-Sillaire 3 & Florence Pasquier 2,3 & Stéphanie Bombois 2,3 & Franck Semah 1,2 Received: 12 April 2018 /Accepted: 27 July 2018 # Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Purpose One can reasonably suppose that cerebrospinal spinal fluid (CSF) biomarkers can identify distinct subgroups of Alzheimer’ s disease (AD) patients. In order to better understand differences in CSF biomarker patterns, we used FDG PET to assess cerebral metabolism in CSF-based subgroups of AD patients. Methods Eighty-five patients fulfilling the criteria for probable early-onset AD (EOAD) underwent lumbar puncture, brain 18 F- FDG PET and MRI. A cluster analysis was performed, with the CSF biomarkers for AD as variables. Vertex-wise, partial- volume-corrected metabolic maps were computed for the patients and compared between the clusters of patients. Linear corre- lations between each CSF biomarker and the metabolic maps were assessed. Results Three clusters emerged. The BAβ42^ cluster contained 32 patients with low levels of Aβ42, while tau and p-tau remained within the normal range. The BAβ42 + tau^ cluster contained 41 patients with low levels of Aβ42 and high levels of tau and p-tau. Lastly, the Btau^ cluster contained 12 patients with very high levels of tau and p-tau and low-normal levels of Aβ42. There were no inter-cluster differences in age, sex ratio, educational level, APOE genotype, disease duration or disease severity. The BAβ42 + tau^ and Btau^ clusters displayed more marked frontal hypometabolism than the BAβ42^ cluster did, and frontal metabolism was significantly negatively correlated with the CSF tau level. The BAβ42^ and BAβ42 + tau^ clusters displayed more marked hypometabolism in the left occipitotemporal region than the Btau^ cluster did, and metabolism in this region was significantly and positively correlated with the CSF Aβ42 level. Conclusion The CSF biomarkers can be used to identify metabolically distinct subgroups of patients with EOAD. Future research should seek to establish whether these biochemical differences have clinical consequences. Keywords FDG-PET . Alzheimer’ s disease . CSF biomarkers * Alice Jaillard alice.jaillard@gmail.com Matthieu Vanhoutte matthieuvanhoutte@gmail.com Aurélien Maureille aurelien.maureille@gmail.com Susanna Schraen susanna.schraen@chru-lille.fr Emilie Skrobala emilie.skrobala@hotmail.fr Xavier Delbeuck Xavier.DELBEUCK@chru-lille.fr Adeline Rollin-Sillaire adeline.rollin@chru-lille.fr Florence Pasquier florence.pasquier@chru-lille.fr Stéphanie Bombois stephanie.bombois@chru-lille.fr Franck Semah franck.semah@chru-lille.fr 1 Nuclear Medicine Department, CHU Lille, F-59000 Lille, France 2 Inserm, U1171, F-59000 Lille, France 3 Neurology Department, CHU Lille, F-59000 Lille, France 4 Department of Biology and Pathology, CHU Lill, F-59000 Lille, France European Journal of Nuclear Medicine and Molecular Imaging https://doi.org/10.1007/s00259-018-4113-1