Plasma phosphorylated tau181 outperforms [18F] fluorodeoxyglucose positron emission tomography in the identification of early Alzheimer disease

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

European Journal of Neurology Pub Date : 2024-10-24 DOI:10.1111/ene.16255

Kely Monica Quispialaya, Joseph Therriault, Antonio Aliaga, Cécile Tissot, Stijn Servaes, Nesrine Rahmouni, Thomas K. Karikari, Andrea L. Benedet, Nicholas J. Ashton, Arthur C. Macedo, Firoza Z. Lussier, Jenna Stevenson, Yi-Ting Wang, Jaime Fernandez Arias, Ali Hosseini, Takashi Matsudaira, Bertrand Jean-Claude, Brian M. Gilfix, Eduardo R. Zimmer, Jean-Paul Soucy, Tharick A. Pascoal, Serge Gauthier, Henrik Zetterberg, Kaj Blennow, Pedro Rosa-Neto, for the Alzheimer's Disease Neuroimaging Initiative

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Abstract

Background and purpose

This study was undertaken to compare the performance of plasma p-tau181 with that of [¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in the identification of early biological Alzheimer disease (AD).

Methods

We included 533 cognitively impaired participants from the Alzheimer's Disease Neuroimaging Initiative. Participants underwent PET scans, biofluid collection, and cognitive tests. Receiver operating characteristic analyses were used to determine the diagnostic accuracy of plasma p-tau181 and [¹⁸F]FDG-PET using clinical diagnosis and core AD biomarkers ([¹⁸F]florbetapir-PET and cerebrospinal fluid [CSF] p-tau181) as reference standards. Differences in the diagnostic accuracy between plasma p-tau181 and [¹⁸F]FDG-PET were determined by bootstrap-based tests. Correlations of [¹⁸F]FDG-PET and plasma p-tau181 with CSF p-tau181, amyloid β (Aβ) PET, and cognitive performance were evaluated to compare associations between measurements.

Results

We observed that both plasma p-tau181 and [¹⁸F]FDG-PET identified individuals with positive AD biomarkers in CSF or on Aβ-PET. In the MCI group, plasma p-tau181 outperformed [¹⁸F]FDG-PET in identifying AD measured by CSF (p = 0.0007) and by Aβ-PET (p = 0.001). We also observed that both plasma p-tau181 and [¹⁸F]FDG-PET metabolism were associated with core AD biomarkers. However, [¹⁸F]FDG-PET uptake was more closely associated with cognitive outcomes (Montreal Cognitive Assessment, Mini-Mental State Examination, Clinical Dementia Rating Sum of Boxes, and logical memory delayed recall, p < 0.001) than plasma p-tau181.

Conclusions

Overall, although both plasma p-tau181 and [¹⁸F]FDG-PET were associated with core AD biomarkers, plasma p-tau181 outperformed [¹⁸F]FDG-PET in identifying individuals with early AD pathophysiology. Taken together, our study suggests that plasma p-tau181 may aid in detecting individuals with underlying early AD.

Abstract Image

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在识别早期阿尔茨海默病方面，血浆磷酸化 tau181 优于 [18F] 氟脱氧葡萄糖正电子发射断层扫描。

背景和目的：本研究旨在比较血浆p-tau181与[18F]氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在识别早期生物阿尔茨海默病（AD）方面的性能：方法：我们纳入了阿尔茨海默病神经影像学倡议的 533 名认知功能受损的参与者。参与者接受了 PET 扫描、生物流体采集和认知测试。以临床诊断和核心AD生物标记物（[18F]氟贝他匹尔-PET和脑脊液[CSF] p-tau181）为参考标准，使用接收器操作特征分析确定血浆p-tau181和[18F]FDG-PET的诊断准确性。血浆p-tau181和[18F]FDG-PET的诊断准确性差异是通过基于引导的检验确定的。评估了[18F]FDG-PET和血浆p-tau181与CSF p-tau181、淀粉样β（Aβ）PET和认知能力之间的相关性，以比较测量结果之间的联系：我们发现血浆p-tau181和[18F]FDG-PET都能识别出CSF或Aβ-PET中AD生物标志物呈阳性的个体。在MCI组中，血浆p-tau181在鉴别CSF（p = 0.0007）和Aβ-PET（p = 0.001）检测出的AD方面优于[18F]FDG-PET。我们还观察到，血浆 p-tau181 和 [18F]FDG-PET 代谢均与 AD 核心生物标志物相关。然而，[18F]FDG-PET 摄取量与认知结果（蒙特利尔认知评估、迷你精神状态检查、临床痴呆评级方框总和、逻辑记忆延迟回忆，P 结论）的关系更为密切：总的来说，虽然血浆p-tau181和[18F]FDG-PET都与AD的核心生物标志物有关，但血浆p-tau181在识别早期AD病理生理学方面优于[18F]FDG-PET。综上所述，我们的研究表明，血浆p-tau181可能有助于检测潜在的早期AD患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Neurology 医学-临床神经学

CiteScore

9.70

自引率

2.00%

发文量

418

审稿时长

1 months

期刊介绍： The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).