Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
Characterizing visual read tau-PET-negative participants with Alzheimer's disease dementia.
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Rikken Roos M, Coomans Emma M, de Koning Lotte A, Visser Denise, Neutelings Eline, den Braber Anouk, Collij Lyduine E, Golla Sandeep S V, Alzheimer's Disease Neuroimaging Initiative, Barkhof Frederik, Visser Pieter Jelle, Scheltens Philip, van der Flier Wiesje M, Boellaard Ronald, Ossenkoppele Rik, Vijverberg Everard G B, van de Giessen Elsmarieke, for ADNI
Аннотация
INTRODUCTION: A subset of amyloid beta (Aβ)-positive Alzheimer's disease (AD) patients is tau-positron emission tomography (PET) negative. We aimed to characterize this subgroup using [18F]flortaucipir PET visual read (VR), as this is important for prognosis and selection for therapies.
METHODS: Aβ-positive VR tau-PET-negative AD dementia patients (AD A+T-) were compared to tau-PET-positive AD patients (AD A+T+) and control groups (CU A-T-; CU A+T-) included from the Amsterdam-based cohort and Alzheimer's Disease Neuroimaging Initiative (ADNI). We compared [18F]flortaucipir binding in an early- and late-stage tau ROI, atrophy, cognition, and co-pathologies.
RESULTS: AD A+T- were older, showed less hippocampal atrophy and slower cognitive decline compared to AD A+T+. In ADNI, AD A+T- showed higher early-stage tau binding compared to both control groups and more late-stage tau compared to CU A-T-, but no tau accumulation over time.
DISCUSSION: VR tau-PET-negative AD patients show neurodegenerative and cognitive processes consistent with the AD trajectory, but milder progression compared to tau-PET-positive AD patients.
HIGHLIGHTS: We used the novel Food and Drug Administration (FDA)-approved VR method for defining tau-PET positivity. AD A+T- patients were older and showed less atrophy and cognitive decline than AD A+T+. We did not find convincing evidence of tau accumulation in AD A+T- or copathologies. The group of AD A+T- patients is likely very heterogeneous.
METHODS: Aβ-positive VR tau-PET-negative AD dementia patients (AD A+T-) were compared to tau-PET-positive AD patients (AD A+T+) and control groups (CU A-T-; CU A+T-) included from the Amsterdam-based cohort and Alzheimer's Disease Neuroimaging Initiative (ADNI). We compared [18F]flortaucipir binding in an early- and late-stage tau ROI, atrophy, cognition, and co-pathologies.
RESULTS: AD A+T- were older, showed less hippocampal atrophy and slower cognitive decline compared to AD A+T+. In ADNI, AD A+T- showed higher early-stage tau binding compared to both control groups and more late-stage tau compared to CU A-T-, but no tau accumulation over time.
DISCUSSION: VR tau-PET-negative AD patients show neurodegenerative and cognitive processes consistent with the AD trajectory, but milder progression compared to tau-PET-positive AD patients.
HIGHLIGHTS: We used the novel Food and Drug Administration (FDA)-approved VR method for defining tau-PET positivity. AD A+T- patients were older and showed less atrophy and cognitive decline than AD A+T+. We did not find convincing evidence of tau accumulation in AD A+T- or copathologies. The group of AD A+T- patients is likely very heterogeneous.