阿尔茨海默病神经影像学倡议
痴呆
载脂蛋白E
内科学
疾病
阿尔茨海默病
肿瘤科
医学
神经影像学
认知功能衰退
磁共振成像
脑脊液
认知
神经心理学
心理学
生物标志物
精神科
化学
放射科
生物化学
作者
Sebastian Palmqvist,Pontus Tideman,Nicholas Cullen,Henrik Zetterberg,Kaj Blennow,Jeffrey L. Dage,Erik Stomrud,Randall J. Bateman,Niklas Mattsson‐Carlgren,Oskar Hansson
出处
期刊:Nature Medicine
[Springer Nature]
日期:2021-05-24
卷期号:27 (6): 1034-1042
被引量:242
标识
DOI:10.1038/s41591-021-01348-z
摘要
A combination of plasma phospho-tau (P-tau) and other accessible biomarkers might provide accurate prediction about the risk of developing Alzheimer's disease (AD) dementia. We examined this in participants with subjective cognitive decline and mild cognitive impairment from the BioFINDER (n = 340) and Alzheimer's Disease Neuroimaging Initiative (ADNI) (n = 543) studies. Plasma P-tau, plasma Aβ42/Aβ40, plasma neurofilament light, APOE genotype, brief cognitive tests and an AD-specific magnetic resonance imaging measure were examined using progression to AD as outcome. Within 4 years, plasma P-tau217 predicted AD accurately (area under the curve (AUC) = 0.83) in BioFINDER. Combining plasma P-tau217, memory, executive function and APOE produced higher accuracy (AUC = 0.91, P < 0.001). In ADNI, this model had similar AUC (0.90) using plasma P-tau181 instead of P-tau217. The model was implemented online for prediction of the individual probability of progressing to AD. Within 2 and 6 years, similar models had AUCs of 0.90-0.91 in both cohorts. Using cerebrospinal fluid P-tau, Aβ42/Aβ40 and neurofilament light instead of plasma biomarkers did not improve the accuracy significantly. The clinical predictions by memory clinic physicians had significantly lower accuracy (4-year AUC = 0.71). In summary, plasma P-tau, in combination with brief cognitive tests and APOE genotyping, might greatly improve the diagnostic prediction of AD and facilitate recruitment for AD trials.
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