
JAMA Network Open, Год журнала: 2025, Номер 8(5), С. e258842 - e258842
Опубликована: Май 9, 2025
Importance As amyloid-targeted therapies have become commercially available, the monitoring of cerebral amyloid angiopathy (CAA), which is an important risk factor for amyloid-related imaging abnormalities, has received increasing attention. However, comprehensive evidence on association between Alzheimer disease (AD) plasma biomarkers and various CAA markers still lacking. Objective To examine with downstream AD in relation to amyloid-β (Aβ) uptake positron emission tomography (PET) whether their interplay associated cognitive changes. Design, Setting, Participants This registry-based cohort study 25 hospitals across South Korea recruited participants aged 45 years or older who were registered January 1, 2016, December 31, 2023. categorized as having no impairment, mild dementia type. Exposures Cerebral assessed by magnetic resonance imaging, including microbleeds (CMBs), cortical superficial siderosis, white matter hyperintensities, lacunes, enlarged perivascular spaces. Main Outcomes Measures Plasma phosphorylated tau-217 (p-tau217) was measured using a commercial assay. Glial fibrillary acidic protein (GFAP) neurofilament light chain (NfL) single-molecule assay single platform. All underwent PET imaging. Associations vascular investigated linear regression. Results A total 1708 included (mean [SD] age, 71.2 [8.4] years; 1044 female [61.1%]). The mean (SD) follow-up period 4.3 (3.1) years. Lobar CMB counts presence biomarkers, p-tau217 (β = 0.12 [95% CI, 0.05-0.18] 0.29 0.12-0.47], respectively), GFAP 0.07 0.03-0.12] 0.20 0.09-0.31], NfL 0.03-0.11] 0.16 0.06-0.25], respectively) without mediation Aβ (indirect effect: lobar CMBs–p-tau217, 59.8% [β (95% 0.03-0.11)]; CMBs-GFAP, 49.3% 0.04 0.01-0.06)]; CMBs-NfL, 20.9% 0.01 0.01-0.03)]; CAA–p-tau217, 50.9% 0.15 0.06-0.24)]; CAA-GFAP, 39.2% 0.08 0.03-0.13)]; CAA-NfL, 19.2% 0.03 0.01-0.05)]). Amyloid-β fully mediated associations siderosis markers. In contrast, hypertensive arteriosclerotic markers, deep CMBs, spaces basal ganglia, only levels 0.01-0.13], 0.08-0.32], 0.14 0.06-0.23], regardless PET. Finally, there interactive CMBs conjunction −0.56 −0.79 −0.34]) −0.44 −0.70 −0.17]) annual Mini-Mental State Examination Conclusions Relevance this type, novel found among declines brain burdens. findings emphasize importance understanding clinical effects abnormality–like upcoming therapies.
Язык: Английский