Neurology · 2024
Comparison of Plasma p-tau217 and [18F]FDG-PET for Identifying Alzheimer Disease in People With Early-Onset or Atypical Dementia.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Quispialaya Kely Monica, Therriault Joseph, Aliaga Antonio, Benedet Andrea L, Ashton Nicholas J, Karikari Thomas, Cassa Macedo Arthur, Rahmouni Nesrine, Tissot Cécile, Fernandez Arias Jaime, Wang Yi-Ting Tina, Trudel Lydia, Hosseini Seyyed Ali, Matsudaira Takashi, Chan Tevy, Pascoal Tharick, Gilfix Brian, Vitali Paolo, Zimmer Eduardo R, Provost Karine, Soucy Jean-Paul, Gauthier Serge, Zetterberg Henrik, Jean-Claude Bertrand J, Blennow Kaj, Rosa-Neto Pedro
Аннотация
BACKGROUND AND OBJECTIVES: To compare the diagnostic performance of an immunoassay for plasma concentrations of phosphorylated tau (p-tau) 217 with visual assessments of fluorine-18 fluorodeoxyglucose [18F]FDG-PET in individuals who meet appropriate use criteria for Alzheimer dementia (AD) biomarker assessments.
METHODS: We performed a retrospective analysis of individuals with early-onset (age <65 years at onset) and/or atypical dementia (features other than memory at onset), who were evaluated at a tertiary care memory clinic. All participants underwent measurements of CSF biomarkers (Aβ42, p-tau181, and total tau levels), as well as [18F]FDG-PET scans, amyloid-PET scans, and plasma p-tau217 quantifications. To determine whether the [18F]FDG-PET images were compatible with AD, images were visually rated by 2 nuclear medicine experts. Using a contingency analysis, we evaluated the accuracy of [18F]FDG-PET scan interpretation and plasma p-tau217 for an AD biomarker profile in CSF and for amyloid-PET positivity.
RESULTS: A total of 81 individuals with early onset and/or atypical dementia were included in this study (mean age = 65 years; 48/81 female (59%). Both [18F]FDG-PET and plasma p-tau217 showed high levels of agreement with reference standard AD biomarkers ([18F]FDG-PET area under the curve [AUC]: 71%; plasma p-tau217 AUC: 81%). Although both biomarkers had similar specificity for AD [18F]FDG-PET: 70%, CI: 0.56-0.81; plasma p-tau217: 70%, CI: 0.56-0.81), plasma p-tau217 had higher sensitivity for AD (plasma p-tau217: 97%, CI: 0.85-0.99 vs [18F]FDG-PET: 73%, CI: 0.57-0.85) (p = 0.01). Overall accuracy was also higher for plasma p-tau217 (AUC = 84%, CI: 0.75-0.93 vs 72%, CI: 0.60-0.83 of [18F]FDG-PET) (p = 0.02). The same pattern of results was observed when using amyloid-PET as the reference standard.
DISCUSSION: Our study provides evidence that plasma p-tau217 has strong discriminative accuracy for AD among patients with early-onset and/or atypical dementia assessed in specialized settings. Future work should replicate these findings in secondary care settings.
METHODS: We performed a retrospective analysis of individuals with early-onset (age <65 years at onset) and/or atypical dementia (features other than memory at onset), who were evaluated at a tertiary care memory clinic. All participants underwent measurements of CSF biomarkers (Aβ42, p-tau181, and total tau levels), as well as [18F]FDG-PET scans, amyloid-PET scans, and plasma p-tau217 quantifications. To determine whether the [18F]FDG-PET images were compatible with AD, images were visually rated by 2 nuclear medicine experts. Using a contingency analysis, we evaluated the accuracy of [18F]FDG-PET scan interpretation and plasma p-tau217 for an AD biomarker profile in CSF and for amyloid-PET positivity.
RESULTS: A total of 81 individuals with early onset and/or atypical dementia were included in this study (mean age = 65 years; 48/81 female (59%). Both [18F]FDG-PET and plasma p-tau217 showed high levels of agreement with reference standard AD biomarkers ([18F]FDG-PET area under the curve [AUC]: 71%; plasma p-tau217 AUC: 81%). Although both biomarkers had similar specificity for AD [18F]FDG-PET: 70%, CI: 0.56-0.81; plasma p-tau217: 70%, CI: 0.56-0.81), plasma p-tau217 had higher sensitivity for AD (plasma p-tau217: 97%, CI: 0.85-0.99 vs [18F]FDG-PET: 73%, CI: 0.57-0.85) (p = 0.01). Overall accuracy was also higher for plasma p-tau217 (AUC = 84%, CI: 0.75-0.93 vs 72%, CI: 0.60-0.83 of [18F]FDG-PET) (p = 0.02). The same pattern of results was observed when using amyloid-PET as the reference standard.
DISCUSSION: Our study provides evidence that plasma p-tau217 has strong discriminative accuracy for AD among patients with early-onset and/or atypical dementia assessed in specialized settings. Future work should replicate these findings in secondary care settings.