Plasma phosphorylated tau181 outperforms [18F] fluorodeoxyglucose positron emission tomography in the identification of early Alzheimer disease

• Published in: European journal of neurology 2024-12, Vol.31 (12), p.e16255-n/a
• Main Authors: Quispialaya, Kely Monica, Therriault, Joseph, Aliaga, Antonio, Tissot, Cécile, Servaes, Stijn, Rahmouni, Nesrine, Karikari, Thomas K., Benedet, Andrea L., Ashton, Nicholas J., Macedo, Arthur C., Lussier, Firoza Z., Stevenson, Jenna, Wang, Yi‐Ting, Arias, Jaime Fernandez, Hosseini, Ali, Matsudaira, Takashi, Jean‐Claude, Bertrand, Gilfix, Brian M., Zimmer, Eduardo R., Soucy, Jean‐Paul, Pascoal, Tharick A., Gauthier, Serge, Zetterberg, Henrik, Blennow, Kaj, Rosa‐Neto, Pedro
• Format: Article
• Language: English
• Subjects: [18F]FDG‐PET; [18F]florbetapir‐PET; [F-18]FDG-PET; [F-18]florbetapir-PET; Aged; Aged, 80 and over; Alzheimer disease; Alzheimer Disease - blood; Alzheimer Disease - cerebrospinal fluid; Alzheimer Disease - diagnosis; Alzheimer Disease - diagnostic imaging; Alzheimer's disease; Amyloid beta-Peptides - blood; Amyloid beta-Peptides - cerebrospinal fluid; Biomarkers; Biomarkers - blood; Biomarkers - cerebrospinal fluid; Cerebrospinal fluid; Cognitive ability; Cognitive Dysfunction - blood; Cognitive Dysfunction - cerebrospinal fluid; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - diagnostic imaging; Dementia and Cognitive Disorders; Dementia disorders; Diagnostic systems; Early Diagnosis; Emissions; Female; Fluorine isotopes; Fluorodeoxyglucose F18; Humans; Male; Medical imaging; Middle Aged; Neurodegenerative diseases; Neuroimaging; Neurologi; Neurology; Original; Performance evaluation; Phosphorylation; Plasma; plasma p-tau181; Positron emission; Positron emission tomography; Radiopharmaceuticals; tau Proteins - blood; tau Proteins - cerebrospinal fluid; Tomography; β-Amyloid
• ISSN: 1351-5101; 1468-1331; 1468-1331
• DOI: 10.1111/ene.16255

Background and purpose This study was undertaken to compare the performance of plasma p‐tau181 with that of [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in the identification of early biological Alzheimer disease (AD). Methods We included 533 cognitively impaired participants from the Alzheimer's Disease Neuroimaging Initiative. Participants underwent PET scans, biofluid collection, and cognitive tests. Receiver operating characteristic analyses were used to determine the diagnostic accuracy of plasma p‐tau181 and [18F]FDG‐PET using clinical diagnosis and core AD biomarkers ([18F]florbetapir‐PET and cerebrospinal fluid [CSF] p‐tau181) as reference standards. Differences in the diagnostic accuracy between plasma p‐tau181 and [18F]FDG‐PET were determined by bootstrap‐based tests. Correlations of [18F]FDG‐PET and plasma p‐tau181 with CSF p‐tau181, amyloid β (Aβ) PET, and cognitive performance were evaluated to compare associations between measurements. Results We observed that both plasma p‐tau181 and [18F]FDG‐PET identified individuals with positive AD biomarkers in CSF or on Aβ‐PET. In the MCI group, plasma p‐tau181 outperformed [18F]FDG‐PET in identifying AD measured by CSF (p = 0.0007) and by Aβ‐PET (p = 0.001). We also observed that both plasma p‐tau181 and [18F]FDG‐PET metabolism were associated with core AD biomarkers. However, [18F]FDG‐PET uptake was more closely associated with cognitive outcomes (Montreal Cognitive Assessment, Mini‐Mental State Examination, Clinical Dementia Rating Sum of Boxes, and logical memory delayed recall, p