Kely Monica Quispialaya, Joseph Therriault, Antonio Aliaga, Andrea L Benedet, Nicholas J Ashton, Thomas Karikari, Arthur Cassa Macedo, Nesrine Rahmouni, Cécile Tissot, Jaime Fernandez Arias, Yi-Ting Tina Wang, Lydia Trudel, Seyyed Ali Hosseini, Takashi Matsudaira, Tevy Chan, Tharick Pascoal, Brian Gilfix, Paolo Vitali, Eduardo R Zimmer, Karine Provost, Jean-Paul Soucy, Serge Gauthier, Henrik Zetterberg, Bertrand J Jean-Claude, Kaj Blennow, Pedro Rosa-Neto
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引用次数: 0
Abstract
Background and objectives: To compare the diagnostic performance of an immunoassay for plasma concentrations of phosphorylated tau (p-tau) 217 with visual assessments of fluorine-18 fluorodeoxyglucose [18F]FDG-PET in individuals who meet appropriate use criteria for Alzheimer dementia (AD) biomarker assessments.
Methods: We performed a retrospective analysis of individuals with early-onset (age <65 years at onset) and/or atypical dementia (features other than memory at onset), who were evaluated at a tertiary care memory clinic. All participants underwent measurements of CSF biomarkers (Aβ42, p-tau181, and total tau levels), as well as [18F]FDG-PET scans, amyloid-PET scans, and plasma p-tau217 quantifications. To determine whether the [18F]FDG-PET images were compatible with AD, images were visually rated by 2 nuclear medicine experts. Using a contingency analysis, we evaluated the accuracy of [18F]FDG-PET scan interpretation and plasma p-tau217 for an AD biomarker profile in CSF and for amyloid-PET positivity.
Results: A total of 81 individuals with early onset and/or atypical dementia were included in this study (mean age = 65 years; 48/81 female (59%). Both [18F]FDG-PET and plasma p-tau217 showed high levels of agreement with reference standard AD biomarkers ([18F]FDG-PET area under the curve [AUC]: 71%; plasma p-tau217 AUC: 81%). Although both biomarkers had similar specificity for AD [18F]FDG-PET: 70%, CI: 0.56-0.81; plasma p-tau217: 70%, CI: 0.56-0.81), plasma p-tau217 had higher sensitivity for AD (plasma p-tau217: 97%, CI: 0.85-0.99 vs [18F]FDG-PET: 73%, CI: 0.57-0.85) (p = 0.01). Overall accuracy was also higher for plasma p-tau217 (AUC = 84%, CI: 0.75-0.93 vs 72%, CI: 0.60-0.83 of [18F]FDG-PET) (p = 0.02). The same pattern of results was observed when using amyloid-PET as the reference standard.
Discussion: Our study provides evidence that plasma p-tau217 has strong discriminative accuracy for AD among patients with early-onset and/or atypical dementia assessed in specialized settings. Future work should replicate these findings in secondary care settings.
期刊介绍：
Neurology, the official journal of the American Academy of Neurology, aspires to be the premier peer-reviewed journal for clinical neurology research. Its mission is to publish exceptional peer-reviewed original research articles, editorials, and reviews to improve patient care, education, clinical research, and professionalism in neurology.
As the leading clinical neurology journal worldwide, Neurology targets physicians specializing in nervous system diseases and conditions. It aims to advance the field by presenting new basic and clinical research that influences neurological practice. The journal is a leading source of cutting-edge, peer-reviewed information for the neurology community worldwide. Editorial content includes Research, Clinical/Scientific Notes, Views, Historical Neurology, NeuroImages, Humanities, Letters, and position papers from the American Academy of Neurology. The online version is considered the definitive version, encompassing all available content.
Neurology is indexed in prestigious databases such as MEDLINE/PubMed, Embase, Scopus, Biological Abstracts®, PsycINFO®, Current Contents®, Web of Science®, CrossRef, and Google Scholar.
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