Diagnosis of Alzheimer's disease using plasma biomarkers adjusted to clinical probability
Therriault, J. (McGill University)
Janelidze, S. (Lund University)
Benedet, A.L. (University of Gothenburg)
Ashton, N.J. (University of Gothenburg)
Arranz Martínez, Javier (Institut de Recerca Sant Pau)
Gonzalez-Escalante, A. (Universitat Pompeu Fabra)
Bellaver, B. (University of Pittsburgh)
Alcolea, Daniel (Institut de Recerca Sant Pau)
Vrillon, A. (Centre de Neurologie Cognitive)
Karim, H. (Ajou University School of Medicine)
Mielke, M.M. (Mayo Clinic Florida (Jacksonville, Estats Units d'Amèrica))
Hyung Hong, C. (Ajou University School of Medicine)
Roh, H.W. (Ajou University School of Medicine)
Contador, José (Hospital del Mar (Barcelona, Catalunya))
Puig Pijoan, A. (ERA-Net on Cardiovascular Diseases Consortium)
Algeciras-Schimnich, A. (Mayo Clinic (Rochester, Estats Units d'Amèrica))
Vemuri, P. (Mayo Clinic (Rochester, Estats Units d'Amèrica))
Graff-Radford, J. (Mayo Clinic Florida (Jacksonville, Estats Units d'Amèrica))
Lowe, V.J. (Mayo Clinic (Rochester, Estats Units d'Amèrica))
Karikari, T.K. (University of Pittsburgh School of Medicine)
Jonaitis, E. (Wisconsin Alzheimer's Disease Research Center)
Brum, W. (Universidad Federal do RioGrande do Sul)
Tissot, C. (Lawrence Berkeley National Laboratory)
Servaes, S. (McGill University)
Rahmouni, N. (McGill University)
Macedo, A.C. (McGill University)
Stevenson, J. (McGill University)
Fernandez-Arias, J. (McGill University)
Wang, Y.T. (McGill University)
Woo, M.S. (University Medical Center Hamburg-Eppendorf)
Friese, M.A. (University Medical Center Hamburg-Eppendorf)
Jia, W.L. (McGill University)
Dumurgier, J. (Centre de Neurologie Cognitive)
Hourregue, C. (Centre de Neurologie Cognitive)
Cognat, E. (Centre de Neurologie Cognitive)
Ferreira, P.L. (Department of Psychiatry. University of Pittsburgh School of Medicine)
Vitali, P. (McGill University)
Johnson, S. (Wisconsin Alzheimer's Disease Research Center)
Pascoal, Tharick (University of Pittsburgh School of Medicine)
Gauthier, S. (McGill University)
Lleó, Alberto (Institut de Recerca Sant Pau)
Paquet, C. (Centre de Neurologie Cognitive)
Petersen, R.C. (Mayo Clinic Florida (Jacksonville, Estats Units d'Amèrica))
Salmon, D. (University of California)
Mattsson-Carlgren, N. (Lund University)
Palmqvist, S. (Skåne University Hospital (Suècia))
Stomrud, E. (Skåne University Hospital (Suècia))
Galasko, D. (University of California)
Son, S.J. (Ajou University School of Medicine)
Zetterberg, H. (Hong Kong Center for Neurodegenerative Diseases)
Fortea, Juan (Institut de Recerca Sant Pau)
Suárez-Calvet, M. (Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable)
Jack Jr, Clifford R (Mayo Clinic (Rochester, Estats Units d'Amèrica))
Blennow, K. (University of Gothenburg)
Hansson, Oskar (Hong Kong Center for Neurodegenerative Diseases)
Rosa-Neto, P. (McGill University)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	Recently approved anti-amyloid immunotherapies for Alzheimer's disease (AD) require evidence of amyloid-β pathology from positron emission tomography (PET) or cerebrospinal fluid (CSF) before initiating treatment. Blood-based biomarkers promise to reduce the need for PET or CSF testing; however, their interpretation at the individual level and the circumstances requiring confirmatory testing are poorly understood. Individual-level interpretation of diagnostic test results requires knowledge of disease prevalence in relation to clinical presentation (clinical pretest probability). Here, in a study of 6,896 individuals evaluated from 11 cohort studies from six countries, we determined the positive and negative predictive value of five plasma biomarkers for amyloid-β pathology in cognitively impaired individuals in relation to clinical pretest probability. We observed that p-tau217 could rule in amyloid-β pathology in individuals with probable AD dementia (positive predictive value above 95%). In mild cognitive impairment, p-tau217 interpretation depended on patient age. Negative p-tau217 results could rule out amyloid-β pathology in individuals with non-AD dementia syndromes (negative predictive value between 90% and 99%). Our findings provide a framework for the individual-level interpretation of plasma biomarkers, suggesting that p-tau217 combined with clinical phenotyping can identify patients where amyloid-β pathology can be ruled in or out without the need for PET or CSF confirmatory testing.
Ajuts:	Instituto de Salud Carlos III PI19/00155
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Nature Aging, Vol. 4 Núm. 11 (november 2024) , p. 1529-1537, ISSN 2662-8465

DOI: 10.1038/s43587-024-00731-y
PMID: 39533113

12 p, 3.5 MB

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