Comparison of Plasma p-tau217 and [18F]FDG-PET for Identifying Alzheimer Disease in People With Early-Onset or Atypical Dementia.

IF 7.7 1区 医学 Q1 CLINICAL NEUROLOGY
Neurology Pub Date : 2025-01-28 Epub Date: 2024-12-23 DOI:10.1212/WNL.0000000000210211
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.

血浆p-tau217与[18F]FDG-PET鉴别早发性或非典型痴呆患者阿尔茨海默病的比较
背景和目的:比较血浆磷酸化tau (p-tau) 217浓度的免疫测定与氟-18氟脱氧葡萄糖[18F]FDG-PET视觉评估在符合适当使用标准的阿尔茨海默氏症(AD)生物标志物评估个体中的诊断性能。方法:我们对早发(18F岁)FDG-PET扫描、淀粉样蛋白- pet扫描和血浆p-tau217定量的个体进行了回顾性分析。为了确定[18F]FDG-PET图像是否与AD兼容,由2名核医学专家对图像进行视觉评分。通过偶发性分析,我们评估了[18F]FDG-PET扫描解释和血浆p-tau217对脑脊液中AD生物标志物谱和淀粉样蛋白- pet阳性的准确性。结果:共有81例早发性和/或非典型痴呆患者被纳入本研究(平均年龄= 65岁;48/81名女性(59%)。[18F]FDG-PET和血浆p-tau217均显示与参考标准AD生物标志物高度一致([18F]FDG-PET曲线下面积[AUC]: 71%;血浆p-tau217 AUC: 81%)。尽管两种生物标志物对AD的特异性相似[18F], FDG-PET: 70%, CI: 0.56-0.81;血浆p-tau217: 70%, CI: 0.56 ~ 0.81),血浆p-tau217对AD的敏感性更高(血浆p-tau217: 97%, CI: 0.85 ~ 0.99 vs [18F]FDG-PET: 73%, CI: 0.57 ~ 0.85) (p = 0.01)。血浆p-tau217的总体准确性也更高(AUC = 84%, CI: 0.75-0.93 vs [18F]FDG-PET的72%,CI: 0.60-0.83) (p = 0.02)。以淀粉样蛋白- pet为参比标准时,观察到相同的结果模式。讨论:我们的研究提供了证据,血浆p-tau217在专门评估的早发性和/或非典型痴呆患者中对AD具有很强的鉴别准确性。未来的工作应该在二级医疗机构中重复这些发现。
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来源期刊
Neurology
Neurology 医学-临床神经学
CiteScore
12.20
自引率
4.00%
发文量
1973
审稿时长
2-3 weeks
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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