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血浆磷酸化 tau181 比 [F] 氟脱氧葡萄糖正电子发射断层扫描在识别早期阿尔茨海默病方面表现更好。

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

机构信息

Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, Montreal, Quebec, Canada.

Montreal Neurological Institute, Montreal, Quebec, Canada.

出版信息

Eur J Neurol. 2024 Dec;31(12):e16255. doi: 10.1111/ene.16255. Epub 2024 Oct 24.

DOI:10.1111/ene.16255
PMID:
39447157
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11555153/
Abstract

BACKGROUND AND PURPOSE

This study was undertaken to compare the performance of plasma p-tau181 with that of [F]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 [F]FDG-PET using clinical diagnosis and core AD biomarkers ([F]florbetapir-PET and cerebrospinal fluid [CSF] p-tau181) as reference standards. Differences in the diagnostic accuracy between plasma p-tau181 and [F]FDG-PET were determined by bootstrap-based tests. Correlations of [F]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 [F]FDG-PET identified individuals with positive AD biomarkers in CSF or on Aβ-PET. In the MCI group, plasma p-tau181 outperformed [F]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 [F]FDG-PET metabolism were associated with core AD biomarkers. However, [F]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 [F]FDG-PET were associated with core AD biomarkers, plasma p-tau181 outperformed [F]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.

摘要

背景与目的

本研究旨在比较血浆 p-tau181 与 [F]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

我们纳入了来自阿尔茨海默病神经影像学倡议的 533 名认知障碍参与者。参与者接受了 PET 扫描、生物流体采集和认知测试。使用临床诊断和核心 AD 生物标志物（[F]florbetapir-PET 和脑脊液 [CSF] p-tau181）作为参考标准，通过接受者操作特征分析来确定血浆 p-tau181 和 [F]FDG-PET 的诊断准确性。通过基于引导的测试确定血浆 p-tau181 和 [F]FDG-PET 之间的诊断准确性差异。评估 [F]FDG-PET 和血浆 p-tau181 与 CSF p-tau181、淀粉样β（Aβ）PET 和认知表现的相关性，以比较测量之间的关联。

结果

我们观察到，血浆 p-tau181 和 [F]FDG-PET 均能识别出脑脊液中 AD 生物标志物阳性或 Aβ-PET 阳性的个体。在 MCI 组中，血浆 p-tau181 在通过 CSF（p=0.0007）和 Aβ-PET（p=0.001）测量 AD 时优于 [F]FDG-PET。我们还观察到，血浆 p-tau181 和 [F]FDG-PET 代谢均与核心 AD 生物标志物相关。然而，与认知结局（蒙特利尔认知评估、简易精神状态检查、临床痴呆评定量表总评分和逻辑记忆延迟回忆，p<0.001）的相关性，[F]FDG-PET 摄取比血浆 p-tau181 更密切。

结论

总体而言，尽管血浆 p-tau181 和 [F]FDG-PET 均与核心 AD 生物标志物相关，但在识别早期 AD 病理生理学患者方面，血浆 p-tau181 优于 [F]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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e779/11555153/7edd9c6452e9/ENE-31-e16255-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e779/11555153/a8dc07e4a18b/ENE-31-e16255-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e779/11555153/26b30dae9057/ENE-31-e16255-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e779/11555153/2979aaac7607/ENE-31-e16255-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e779/11555153/7edd9c6452e9/ENE-31-e16255-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e779/11555153/a8dc07e4a18b/ENE-31-e16255-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e779/11555153/26b30dae9057/ENE-31-e16255-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e779/11555153/2979aaac7607/ENE-31-e16255-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e779/11555153/7edd9c6452e9/ENE-31-e16255-g004.jpg

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