Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada.
Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
Alzheimers Dement. 2023 Nov;19(11):4967-4977. doi: 10.1002/alz.13026. Epub 2023 Apr 20.
Plasma biomarkers are promising tools for Alzheimer's disease (AD) diagnosis, but comparisons with more established biomarkers are needed.
We assessed the diagnostic performance of p-tau , p-tau , and p-tau in plasma and CSF in 174 individuals evaluated by dementia specialists and assessed with amyloid-PET and tau-PET. Receiver operating characteristic (ROC) analyses assessed the performance of plasma and CSF biomarkers to identify amyloid-PET and tau-PET positivity.
Plasma p-tau biomarkers had lower dynamic ranges and effect sizes compared to CSF p-tau. Plasma p-tau (AUC = 76%) and p-tau (AUC = 82%) assessments performed inferior to CSF p-tau (AUC = 87%) and p-tau (AUC = 95%) for amyloid-PET positivity. However, plasma p-tau (AUC = 91%) had diagnostic performance indistinguishable from CSF (AUC = 94%) for amyloid-PET positivity.
Plasma and CSF p-tau had equivalent diagnostic performance for biomarker-defined AD. Our results suggest that plasma p-tau may help reduce the need for invasive lumbar punctures without compromising accuracy in the identification of AD.
p-tau in plasma performed equivalent to p-tau in CSF for the diagnosis of AD, suggesting the increased accessibility of plasma p-tau is not offset by lower accuracy. p-tau biomarkers in plasma had lower mean fold-changes between amyloid-PET negative and positive groups than p-tau biomarkers in CSF. CSF p-tau biomarkers had greater effect sizes than plasma p-tau biomarkers when differentiating between amyloid-PET positive and negative groups. Plasma p-tau and plasma p-tau performed worse than p-tau and p-tau in CSF for AD diagnosis.
血浆生物标志物是阿尔茨海默病（AD）诊断的有前途的工具，但仍需要与更成熟的生物标志物进行比较。
我们评估了 174 名经痴呆专家评估并接受淀粉样蛋白-PET 和 tau-PET 检查的个体血浆和 CSF 中 p-tau 、 p-tau 和 p-tau 的诊断性能。接收者操作特征（ROC）分析评估了血浆和 CSF 生物标志物识别淀粉样蛋白-PET 和 tau-PET 阳性的性能。
与 CSF p-tau 相比，血浆 p-tau 生物标志物的动态范围和效应量较低。血浆 p-tau（AUC=76%）和 p-tau（AUC=82%）评估的表现不如 CSF p-tau（AUC=87%）和 p-tau（AUC=95%）对淀粉样蛋白-PET 阳性的诊断性能。然而，血浆 p-tau（AUC=91%）对淀粉样蛋白-PET 阳性的诊断性能与 CSF（AUC=94%）相当。
血浆和 CSF p-tau 对生物标志物定义的 AD 具有同等的诊断性能。我们的结果表明，在不影响 AD 识别准确性的情况下，血浆 p-tau 可能有助于减少对侵入性腰椎穿刺的需求。
血浆 p-tau 对 AD 的诊断与 CSF p-tau 相当，这表明血浆 p-tau 的可及性增加并没有因准确性降低而抵消。与 CSF p-tau 生物标志物相比，区分淀粉样蛋白-PET 阳性和阴性组时，血浆 p-tau 生物标志物的平均倍数变化较小。当区分淀粉样蛋白-PET 阳性和阴性组时，CSF p-tau 生物标志物的效应量大于血浆 p-tau 生物标志物。与 CSF 中的 p-tau 和 p-tau 相比，血浆中的 p-tau 和 p-tau 在 AD 诊断中表现更差。
