Schwarz Julian Alexander, Schulz Pauline, Utz Janine, Rudtke Laura, Jablonowski Johannes, Klement Neele, Lewczuk Piotr, Kornhuber Johannes, Maler Juan Manuel, Oberstein Timo Jan
Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany.
Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-267 Białystok, Poland.
Brain Sci. 2025 Mar 23;15(4):334. doi: 10.3390/brainsci15040334.
: The ERlangen Score (ERS) and the pTau/Aβ1-42 ratio are dementia risk scores that use only surrogate markers of amyloid and tau pathology, whose performance has taken on added importance with the advent of anti-amyloid antibody therapies. Direct comparisons between the scores are limited, which is why the performance of the ERlangen Score (ERS) and the pTau/Aβ1-42 ratio in predicting cognitive decline and dementia risk were compared. : Measurements of Aβ1-42, Aβ1-40, and pTau181 were conducted in cerebrospinal fluid samples using immunoassays. Linear mixed models and the area under the receiver operating characteristic curve (AUC, receiver operating characteristic = ROC) of 259 non-demented subjects were calculated. : The pTau/Aβ1-42 ratio correctly identified 55 out of 60 individuals with a positive Aβ1-42/Aβ1-40 ratio and pTau181 as having Alzheimer's disease (AD), while the ERS correctly identified all of these individuals. The model using the ERS to predict cognitive trajectories (Akaike Information Criterion AIC = 2365) exhibited a marginally superior fit than the model using the pTau/Aβ1-42 ratio (AIC = 2371). There was no statistically significant difference in the AUC of the ERS (0.717) for dementia risk compared to the pTau/Aβ1-42 ratio (0.739), = 0.179. However, when the Aβ1-42/Aβ1-40 ratio was not included in the ERS (AUC = 0.685), the pTau/Aβ1-42 score was found to be statistically significantly better, = 0.007. : The ERS showed an advantage in grouping, identifying all patients with a positive Aβ1-42/Aβ1-40 ratio and elevated pTau181 as having AD. The ERS and pTau/Aβ1-42 ratio were comparable in predicting dementia or cognitive decline. However, when the Aβ1-42/Aβ1-40 ratio is not available, the pTau/Aβ1-42 ratio should be preferred.
埃尔朗根评分（ERS）和pTau/Aβ1-42比值是痴呆风险评分，它们仅使用淀粉样蛋白和tau蛋白病理的替代标志物，随着抗淀粉样蛋白抗体疗法的出现，其性能变得更加重要。各评分之间的直接比较有限，这就是比较埃尔朗根评分（ERS）和pTau/Aβ1-42比值在预测认知衰退和痴呆风险方面性能的原因。：使用免疫测定法对脑脊液样本中的Aβ1-42、Aβ1-40和pTau181进行测量。计算了259名非痴呆受试者的线性混合模型和受试者工作特征曲线下面积（AUC，受试者工作特征=ROC）。：pTau/Aβ1-42比值正确识别出60名Aβ1-42/Aβ1-40比值和pTau181呈阳性的个体中有55名患有阿尔茨海默病（AD），而ERS正确识别出了所有这些个体。使用ERS预测认知轨迹的模型（赤池信息准则AIC = 2365）显示出比使用pTau/Aβ1-42比值的模型（AIC = 2371）略优的拟合度。与pTau/Aβ1-42比值（0.739）相比，ERS用于痴呆风险的AUC（0.717）无统计学显著差异，P = 0.179。然而，当ERS中不包括Aβ1-42/Aβ1-40比值时（AUC = 0.685），发现pTau/Aβ1-42评分在统计学上显著更好，P = 0.007。：ERS在分组方面显示出优势，将所有Aβ1-42/Aβ1-40比值为阳性且pTau181升高的患者识别为患有AD。ERS和pTau/Aβ1-42比值在预测痴呆或认知衰退方面具有可比性。然而，当无法获得Aβ1-42/Aβ1-40比值时，应优先选择pTau/Aβ1-42比值。
