Change in Cerebrospinal Fluid Tau Microtubule Binding Region Detects Symptom Onset, Cognitive Decline, Tangles, and Atrophy in Dominantly Inherited Alzheimer's Disease.
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Horie Kanta, Li Yan, Barthélemy Nicolas R, Gordon Brian, Hassenstab Jason, Benzinger Tammie L S, Fagan Anne M, Morris John C, Karch Celeste M, Xiong Chengjie, Allegri Ricardo, Mendez Patricio Chrem, Ikeuchi Takeshi, Kasuga Kensaku, Noble James, Farlow Martin, Chhatwal Jasmeer, Day Gregory, Schofield Peter R, Masters Colin L, Levin Johannes, Jucker Mathias, Lee Jae-Hong, Roh Jee Hoon, Sato Chihiro, Sachdev Pallavi, Koyama Akihiko, Reyderman Larisa, Bateman Randall J, McDade Eric, Dominantly Inherited Alzheimer Network
Аннотация
METHODS: Cross-sectional and longitudinal CSF from 229 DIAD mutation carriers and 130 mutation non-carriers had sequential characterization of N-terminal/mid-domain phosphorylated tau (p-tau) followed by MTBR-tau species and tau positron emission tomography (tau PET), other soluble tau and amyloid biomarkers, comprehensive clinical and cognitive assessments, and brain magnetic resonance imaging of atrophy.
RESULTS: CSF MTBR-tau species located within the putative "border" region and one species corresponding to the "core" region of aggregates in neurofibrillary tangles (NFTs) increased during the presymptomatic stage and decreased during the symptomatic stage. The "border" MTBR-tau species were associated with amyloid pathology and CSF p-tau; whereas the "core" MTBR-tau species were associated stronger with tau PET and CSF measures of neurodegeneration. The ratio of the border to the core species provided a continuous measure of increasing amounts that tracked clinical progression and NFTs.
INTERPRETATION: Changes in CSF soluble MTBR-tau species preceded the onset of dementia, tau tangle increase, and atrophy in DIAD. The ratio of 4R-specific MTBR-tau (border) to the NFT (core) MTBR-tau species corresponds to the pathology of NFTs in DIAD and change with disease progression. The dynamics between different MTBR-tau species in the CSF may serve as a marker of tau-related disease progression and target engagement of anti-tau therapeutics. ANN NEUROL 2023;93:1158-1172.