Where Do Plasma Biomarkers fit in With Current Alzheimer's Disease Detection?

IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY American Journal of Geriatric Psychiatry Pub Date : 2024-10-01 DOI:10.1016/j.jagp.2024.09.015
Ariel Gildengers, Andrea M Weinstein, Swathi Gujral, Xuemei Zeng, Jihui L Diaz, Tara K Lafferty, Matthew Cowie, James E Emanuel, Oscar Lopez, Sarah K Royse, Brian Lopresti, Thomas K Karikari
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Abstract

Objectives: We examine the clinical utility of plasma-based detection for Alzheimer's disease (AD) pathophysiology in older adults with mild cognitive impairment (MCI) and whether cognitive screening can inform when to use plasma-based AD tests.

Methods: Seventy-four community-dwelling older adults with MCI had testing with plasma phosphorylated tau (p-tau) 217 and 181, positron emission tomography (PET) imaging for amyloid beta (Aβ), and cognitive assessment. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic value of plasma p-tau.

Results: Plasma p-tau217 distinguished MCI participants who had PET imaging evidence of Aβ accumulation from those without (AUC of 0.92, specificity of 0.96, and sensitivity of 0.90), outperforming plasma p-tau181 (AUC of 0.76, specificity of 0.87 and sensitivity of 0.59) for the same purpose. Of the 60 MCI participants that were amnestic, 22 were Aβ+. The 14 participants that were nonamnestic were all Aβ-.

Conclusions: Our findings support the clinical use of plasma p-tau, particularly p-tau217, for patient detection of AD pathophysiology in older adults with amnestic MCI, but not in those who are nonamnestic.

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血浆生物标志物在目前的阿尔茨海默病检测中处于什么位置?
目的:我们研究了基于血浆的阿尔茨海默病(AD)病理生理学检测在轻度认知障碍(MCI)老年人中的临床实用性,以及认知筛查能否为何时使用认知筛查提供依据:我们研究了基于血浆的阿尔茨海默病(AD)病理生理学检测对患有轻度认知障碍(MCI)的老年人的临床实用性,以及认知筛查能否为何时使用基于血浆的AD检测提供依据:74名患有MCI的社区老年人接受了血浆磷酸化tau(p-tau)217和181检测、淀粉样β(Aβ)正电子发射断层扫描(PET)成像和认知评估。采用接收者操作特征(ROC)分析评估血浆p-tau的诊断价值:血浆p-tau217能将有PET成像证据显示Aβ积聚的MCI患者与没有Aβ积聚证据的患者区分开来(AUC为0.92,特异性为0.96,灵敏度为0.90),在同一目的上优于血浆p-tau181(AUC为0.76,特异性为0.87,灵敏度为0.59)。在60名有失忆症的MCI患者中,22人是Aβ+。结论:我们的研究结果支持在临床上使用血浆Aβ检测MCI:我们的研究结果支持在临床上使用血浆p-tau,尤其是p-tau217,来检测患有失忆性MCI的老年人的AD病理生理学,但不支持在那些非失忆性MCI患者中使用血浆p-tau来检测AD病理生理学。
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来源期刊
CiteScore
13.00
自引率
4.20%
发文量
381
审稿时长
26 days
期刊介绍: The American Journal of Geriatric Psychiatry is the leading source of information in the rapidly evolving field of geriatric psychiatry. This esteemed journal features peer-reviewed articles covering topics such as the diagnosis and classification of psychiatric disorders in older adults, epidemiological and biological correlates of mental health in the elderly, and psychopharmacology and other somatic treatments. Published twelve times a year, the journal serves as an authoritative resource for professionals in the field.
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Editorial Board Table of Contents In This Issue Information for Subscribers Suicidal Behavior in Older Adults With Cognitive Impairment.
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