Cerebral Amyloid Angiopathy and Downstream Alzheimer Disease Plasma Biomarkers DOI Creative Commons
Sung Hoon Kang, Eun Hye Lee, Young Ju Kim

и другие.

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

Tailoring thresholds for interpreting plasma p-tau217 levels DOI

Jin Seok Ahn,

Eun Hye Lee, Heejin Yoo

и другие.

Journal of Neurology Neurosurgery & Psychiatry, Год журнала: 2025, Номер unknown, С. jnnp - 335830

Опубликована: Май 24, 2025

Background Plasma phosphorylated tau (p-tau) 217 test has emerged as a minimally invasive and accessible alternative to positron emission tomography imaging cerebrospinal fluid analysis for Alzheimer’s disease (AD) diagnostics. However, the diagnostic performance of p-tau217 across diverse cognitive demographic subgroups remains underexplored. This multicentre cross-sectional study aimed assess utility plasma using double cut-off approach in large, cohort, focusing on subgroup analyses based status, age, sex, body mass index APOE ε4 carrier status. Methods levels were analysed cognitively unimpaired (CU) impaired (CI) individuals. Double cut-offs selected classify participants into amyloid-negative, intermediate amyloid-positive groups. Diagnostic metrics including sensitivity, specificity, positive predictive value negative evaluated subgroups, tailored strategies explored specific populations. Results The optimal differed between CU CI In group, accuracy was consistently high all meeting confirmatory standards with sensitivity specificity ≥90%. appropriate varied by subgroup. Participants aged <65 years required improve 85.0% maintain at 95.7%. Conclusion demonstrated robust highlighted importance thresholds These findings support integration clinical workflows AD diagnostics, emphasising its potential early detection risk stratification.

Язык: Английский

Процитировано

1
Fortschritte und Herausforderungen der Alzheimer-Diagnostik DOI

Peter Findeisen

Trillium Diagnostik, Год журнала: 2025, Номер 23(1), С. 44 - 46

Опубликована: Март 20, 2025

Процитировано

0
Cerebral Amyloid Angiopathy and Downstream Alzheimer Disease Plasma Biomarkers DOI Creative Commons
Sung Hoon Kang, Eun Hye Lee, Young Ju Kim

и другие.

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

Процитировано

0