Gildengers Ariel, Weinstein Andrea M, Gujral Swathi, Zeng Xuemei, Diaz Jihui L, Lafferty Tara K, Cowie Matthew, Emanuel James E, Lopez Oscar, Royse Sarah K, Lopresti Brian, Karikari Thomas K
Department of Psychiatry (AG, AMW, SG, XZ, TKL, MC, JEE, TKK), University of Pittsburgh School of Medicine, Pittsburgh, PA.
Department of Psychiatry (AG, AMW, SG, XZ, TKL, MC, JEE, TKK), University of Pittsburgh School of Medicine, Pittsburgh, PA.
Am J Geriatr Psychiatry. 2025 Apr;33(4):428-437. doi: 10.1016/j.jagp.2024.09.015. Epub 2024 Oct 1.
We examine the clinical utility of plasma-based detection for Alzheimer's disease (AD) pathophysiology in older adults with mild cognitive impairment (MCI) and whether cognitive screening can inform when to use plasma-based AD tests.
Seventy-four community-dwelling older adults with MCI had testing with plasma phosphorylated tau (p-tau) 217 and 181, positron emission tomography (PET) imaging for amyloid beta (Aβ), and cognitive assessment. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic value of plasma p-tau.
Plasma p-tau217 distinguished MCI participants who had PET imaging evidence of Aβ accumulation from those without (AUC of 0.92, specificity of 0.96, and sensitivity of 0.90), outperforming plasma p-tau181 (AUC of 0.76, specificity of 0.87 and sensitivity of 0.59) for the same purpose. Of the 60 MCI participants that were amnestic, 22 were Aβ+. The 14 participants that were nonamnestic were all Aβ-.
Our findings support the clinical use of plasma p-tau, particularly p-tau217, for patient detection of AD pathophysiology in older adults with amnestic MCI, but not in those who are nonamnestic.
我们研究了基于血浆检测在轻度认知障碍（MCI）老年人中对阿尔茨海默病（AD）病理生理学的临床实用性，以及认知筛查能否为何时使用基于血浆的AD检测提供信息。
74名居住在社区的MCI老年人接受了血浆磷酸化tau蛋白（p-tau）217和181检测、淀粉样β蛋白（Aβ）的正电子发射断层扫描（PET）成像以及认知评估。采用受试者操作特征（ROC）分析来评估血浆p-tau的诊断价值。
血浆p-tau217能够区分有PET成像证据显示Aβ积累的MCI参与者和没有该证据的参与者（曲线下面积为0.92，特异性为0.96，敏感性为0.90），在这一目的上优于血浆p-tau181（曲线下面积为0.76，特异性为0.87，敏感性为0.59）。在60名遗忘型MCI参与者中，22名是Aβ阳性。14名非遗忘型参与者均为Aβ阴性。
我们的研究结果支持在有遗忘型MCI的老年人中使用血浆p-tau，尤其是p-tau217来检测AD病理生理学，但不适用于非遗忘型老年人。
