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Villemagne VL, Leuzy A, Bohorquez SS, Bullich S, Shimada H, Rowe CC, Bourgeat P, Lopresti B, Huang K, Krishnadas N, Fripp J, Takado Y, Gogola A, Minhas D, Weimer R, Higuchi M, Stephens A, Hansson O, Doré V. CenTauR: Toward a universal scale and masks for standardizing tau imaging studies. Alzheimers Dement (Amst) 2023; 15:e12454. [PMID: 37424964 PMCID: PMC10326476 DOI: 10.1002/dad2.12454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Recently, an increasing number of tau tracers have become available. There is a need to standardize quantitative tau measures across tracers, supporting a universal scale. We developed several cortical tau masks and applied them to generate a tau imaging universal scale. METHOD One thousand forty-five participants underwent tau scans with either 18F-flortaucipir, 18F-MK6240, 18F-PI2620, 18F-PM-PBB3, 18F-GTP1, or 18F-RO948. The universal mask was generated from cognitively unimpaired amyloid beta (Aβ)- subjects and Alzheimer's disease (AD) patients with Aβ+. Four additional regional cortical masks were defined within the constraints of the universal mask. A universal scale, the CenTauRz, was constructed. RESULTS None of the regions known to display off-target signal were included in the masks. The CenTauRz allows robust discrimination between low and high levels of tau deposits. DISCUSSION We constructed several tau-specific cortical masks for the AD continuum and a universal standard scale designed to capture the location and degree of abnormality that can be applied across tracers and across centers. The masks are freely available at https://www.gaain.org/centaur-project.
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Affiliation(s)
- Victor L. Villemagne
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
| | - Antoine Leuzy
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
| | | | | | - Hitoshi Shimada
- Department of Functional Brain ImagingNational Institutes for Quantum and Radiological Science and TechnologyChibaJapan
- Brain Research InstituteNiigata UniversityNiigataJapan
| | - Christopher C. Rowe
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
- Florey Department of Neurosciences & Mental HealthThe University of MelbourneMelbourneParkvilleAustralia
- The Australian Dementia Network (ADNeT)MelbourneVictoriaAustralia
| | - Pierrick Bourgeat
- Health and Biosecurity FlagshipThe Australian eHealth Research CentreCSIROBrisbaneQueenslandAustralia
| | - Brian Lopresti
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Kun Huang
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
| | - Natasha Krishnadas
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
- Florey Institute of Neurosciences & Mental HealthParkvilleVictoriaAustralia
| | - Jurgen Fripp
- Health and Biosecurity FlagshipThe Australian eHealth Research CentreCSIROBrisbaneQueenslandAustralia
| | - Yuhei Takado
- Department of Functional Brain ImagingNational Institutes for Quantum and Radiological Science and TechnologyChibaJapan
| | - Alexandra Gogola
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Davneet Minhas
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Makoto Higuchi
- Department of Functional Brain ImagingNational Institutes for Quantum and Radiological Science and TechnologyChibaJapan
| | | | - Oskar Hansson
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
- Memory ClinicSkåne University HospitalMalmöSweden
| | - Vincent Doré
- Department of Molecular Imaging & TherapyAustin HealthMelbourneVictoriaAustralia
- Health and Biosecurity FlagshipThe Australian eHealth Research CentreCSIROHeidelbergVictoriaAustralia
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Leuzy A, Binette AP, Vogel JW, Klein G, Borroni E, Tonietto M, Strandberg O, Mattsson-Carlgren N, Palmqvist S, Pontecorvo MJ, Iaccarino L, Stomrud E, Ossenkoppele R, Smith R, Hansson O. Comparison of Group-Level and Individualized Brain Regions for Measuring Change in Longitudinal Tau Positron Emission Tomography in Alzheimer Disease. JAMA Neurol 2023; 80:614-623. [PMID: 37155176 PMCID: PMC10167602 DOI: 10.1001/jamaneurol.2023.1067] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/15/2023] [Indexed: 05/10/2023]
Abstract
Importance Longitudinal tau positron emission tomography (PET) is a relevant outcome in clinical trials evaluating disease-modifying therapies in Alzheimer disease (AD). A key unanswered question is whether the use of participant-specific (individualized) regions of interest (ROIs) is superior to conventional approaches where the same ROI (group-level) is used for each participant. Objective To compare group- and participant-level ROIs in participants at different stages of the AD clinical continuum in terms of annual percentage change in tau-PET standardized uptake value ratio (SUVR) and sample size requirements. Design, Setting, and Participants This was a longitudinal cohort study with consecutive participant enrollment between September 18, 2017, and November 15, 2021. Included in the analysis were participants with mild cognitive impairment and AD dementia from the prospective and longitudinal Swedish Biomarkers For Identifying Neurodegenerative Disorders Early and Reliably 2 (BioFINDER-2) study; in addition, a validation sample (the AVID 05e, Expedition-3, Alzheimer's Disease Neuroimaging Initiative [ADNI], and BioFINDER-1 study cohorts) was also included. Exposures Tau PET (BioFINDER-2, [18F]RO948; validation sample, [18F]flortaucipir), 7 group-level (5 data-driven stages, meta-temporal, whole brain), and 5 individualized ROIs. Main Outcomes and Measures Annual percentage change in tau-PET SUVR across ROIs. Sample size requirements in simulated clinical trials using tau PET as an outcome were also calculated. Results A total of 215 participants (mean [SD] age, 71.4 (7.5) years; 111 male [51.6%]) from the BioFINDER-2 study were included in this analysis: 97 amyloid-β (Aβ)-positive cognitively unimpaired (CU) individuals, 77 with Aβ-positive mild cognitive impairment (MCI), and 41 with AD dementia. In the validation sample were 137 Aβ-positive CU participants, 144 with Aβ-positive MCI, and 125 with AD dementia. Mean (SD) follow-up time was 1.8 (0.3) years. Using group-level ROIs, the largest annual percentage increase in tau-PET SUVR in Aβ-positive CU individuals was seen in a composite ROI combining the entorhinal cortex, hippocampus, and amygdala (4.29%; 95% CI, 3.42%-5.16%). In individuals with Aβ-positive MCI, the greatest change was seen in the temporal cortical regions (5.82%; 95% CI, 4.67%-6.97%), whereas in those with AD dementia, the greatest change was seen in the parietal regions (5.22%; 95% CI, 3.95%-6.49%). Significantly higher estimates of annual percentage change were found using several of the participant-specific ROIs. Importantly, the simplest participant-specific approach, where change in tau PET was calculated in an ROI that best matched the participant's data-driven disease stage, performed best in all 3 subgroups. For the power analysis, sample size reductions for the participant-specific ROIs ranged from 15.94% (95% CI, 8.14%-23.74%) to 72.10% (95% CI, 67.10%-77.20%) compared with the best-performing group-level ROIs. Findings were replicated using [18F]flortaucipir. Conclusions and Relevance Finding suggest that certain individualized ROIs carry an advantage over group-level ROIs for assessing longitudinal tau changes and increase the power to detect treatment effects in AD clinical trials using longitudinal tau PET as an outcome.
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Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Jacob W. Vogel
- Penn/CHOP Lifespan Brain Institute, University of Pennsylvania, Philadelphia
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | | | | | | | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
- Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Michael J. Pontecorvo
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
- Eli Lilly and Company, Indianapolis, Indiana
| | - Leonardo Iaccarino
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
- Eli Lilly and Company, Indianapolis, Indiana
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
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3
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Santillo AF, Leuzy A, Honer M, Landqvist Waldö M, Tideman P, Harper L, Ohlsson T, Moes S, Giannini L, Jögi J, Groot C, Ossenkoppele R, Strandberg O, van Swieten J, Smith R, Hansson O. [ 18F]RO948 tau positron emission tomography in genetic and sporadic frontotemporal dementia syndromes. Eur J Nucl Med Mol Imaging 2023; 50:1371-1383. [PMID: 36513817 PMCID: PMC10027632 DOI: 10.1007/s00259-022-06065-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To examine [18F]RO948 retention in FTD, sampling the underlying protein pathology heterogeneity. METHODS A total of 61 individuals with FTD (n = 35), matched cases of AD (n = 13) and Aβ-negative cognitively unimpaired individuals (n = 13) underwent [18F]RO948PET and MRI. FTD included 21 behavioral variant FTD (bvFTD) cases, 11 symptomatic C9orf72 mutation carriers, one patient with non-genetic bvFTD-ALS, one individual with bvFTD due to a GRN mutation, and one due to a MAPT mutation (R406W). Tracer retention was examined using a region-of-interest and voxel-wise approaches. Two individuals (bvFTD due to C9orf72) underwent postmortem neuropathological examination. Tracer binding was additionally assessed in vitro using [3H]RO948 autoradiography in six separate cases. RESULTS [18F]RO948 retention across ROIs was clearly lower than in AD and comparable to that in Aβ-negative cognitively unimpaired individuals. Only minor loci of tracer retention were seen in bvFTD; these did not overlap with the observed cortical atrophy in the cases, the expected pattern of atrophy, nor the expected or verified protein pathology distribution. Autoradiography analyses showed no specific [3H]RO948 binding. The R406W MAPT mutation carriers were clear exceptions with AD-like retention levels and specific in-vitro binding. CONCLUSION [18F]RO948 uptake is not significantly increased in the majority of FTD patients, with a clear exception being specific MAPT mutations.
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Affiliation(s)
- Alexander F Santillo
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden.
- Memory Clinic, Skåne University Hospital, SE-20502, Malmö, Sweden.
| | - Antoine Leuzy
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden
| | - Michael Honer
- Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche, Basel, Switzerland
| | - Maria Landqvist Waldö
- Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Pontus Tideman
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden
| | - Luke Harper
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden
| | - Tomas Ohlsson
- Radiation Physics, Skane University Hospital, Scania, Sweden
| | - Svenja Moes
- Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche, Basel, Switzerland
| | - Lucia Giannini
- Alzheimer Center, Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jonas Jögi
- Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Colin Groot
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden
| | - Rik Ossenkoppele
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Olof Strandberg
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden
| | - John van Swieten
- Alzheimer Center, Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ruben Smith
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Oskar Hansson
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund/Malmö, Sweden
- Memory Clinic, Skåne University Hospital, SE-20502, Malmö, Sweden
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Ferreira PC, Bellaver B, Povala G, Brum WS, Tissot C, Badji A, Sloan ME, Benedet AL, Rosa-Neto P, Ashton NJ, Pascoal TA, Leuzy A, Zimmer ER. Endocannabinoid System Biomarkers in Alzheimer's Disease. Cannabis Cannabinoid Res 2023; 8:77-91. [PMID: 36394442 PMCID: PMC10081722 DOI: 10.1089/can.2022.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Alterations in the endocannabinoid system (ES) have been described in Alzheimer's disease (AD) pathophysiology. In the past years, multiple ES biomarkers have been developed, promising to advance our understanding of ES changes in AD. Discussion: ES biomarkers, including positron emission tomography with cannabinoid receptors tracers and biofluid-based endocannabinoids, are associated with AD disease progression and pathological features. Conclusion: Although not specific enough for AD diagnosis, ES biomarkers hold promise for prognosis, drug-target engagement, and a better understanding of the disease. Here, we summarize currently available ES biomarker findings and discuss their potential applications in the AD research field.
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Affiliation(s)
- Pâmela C.L. Ferreira
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Neurology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Bruna Bellaver
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Neurology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Guilherme Povala
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Neurology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Wagner S. Brum
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Cécile Tissot
- Department of Neurology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Canada
| | - Atef Badji
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Theme Aging, Huddinge, Sweden
| | - Matthew E. Sloan
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Andréa L. Benedet
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Canada
| | - Nicholas J. Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, United Kingdom
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, United Kingdom
| | - Tharick A. Pascoal
- Department of Neurology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Eduardo R. Zimmer
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada
- Department of Pharmacology, UFRGS, Porto Alegre, Brazil
- Graduate Program in Biological Sciences: Pharmacology and Therapeutics, UFRGS, Porto Alegre, Brazil
- Brain Institute of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
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5
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Leuzy A, Mattsson-Carlgren N, Cullen NC, Stomrud E, Palmqvist S, La Joie R, Iaccarino L, Zetterberg H, Rabinovici G, Blennow K, Janelidze S, Hansson O. Robustness of CSF Aβ42/40 and Aβ42/P-tau181 measured using fully automated immunoassays to detect AD-related outcomes. Alzheimers Dement 2023. [PMID: 36681387 DOI: 10.1002/alz.12897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/26/2022] [Accepted: 11/10/2022] [Indexed: 01/23/2023]
Abstract
INTRODUCTION This study investigated the comparability of cerebrospinal fluid (CSF) cutoffs for Elecsys immunoassays for amyloid beta (Aβ)42/Aβ40 or Aβ42/phosphorylated tau (p-tau)181 and the effects of measurement variability when predicting Alzheimer's disease (AD)-related outcomes (i.e., Aβ-positron emission tomography [PET] visual read and AD neuropathology). METHODS We studied 750 participants (BioFINDER study, Alzheimer's Disease Neuroimaging Initiative [ADNI], and University of California San Francisco [UCSF]). Youden's index was used to identify cutoffs and to calculate accuracy (Aβ-PET visual read as outcome). Using longitudinal variability in Aβ-negative controls, we identified a gray zone around cut-points where the risk of an inconsistent predicted outcome was >5%. RESULTS For Aβ42/Aβ40, cutoffs across cohorts were <0.059 (BioFINDER), <0.057 (ADNI), and <0.058 (UCSF). For Aβ42/p-tau181, cutoffs were <41.90 (BioFINDER), <39.20 (ADNI), and <46.02 (UCSF). Accuracy was ≈90% for both Aβ42/Aβ40 and Aβ42/p-tau181 using these cutoffs. Using Aβ-PET as an outcome, 8.7% of participants fell within a gray zone interval for Aβ42/Aβ40, compared to 4.5% for Aβ42/p-tau181. Similar findings were observed using a measure of overall AD neuropathologic change (7.7% vs. 3.3%). In a subset with CSF and plasma Aβ42/40, the number of individuals within the gray zone was ≈1.5 to 3 times greater when using plasma Aβ42/40. DISCUSSION CSF Aβ42/p-tau181 was more robust to the effects of measurement variability, suggesting that it may be the preferred Elecsys-based measure in clinical practice and trials.
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Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Nicholas C Cullen
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA
| | - Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK.,Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Gil Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA.,Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, California, USA.,Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, California, USA.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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6
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Pascoal TA, Leuzy A, Therriault J, Chamoun M, Lussier F, Tissot C, Strandberg O, Palmqvist S, Stomrud E, Ferreira PCL, Ferrari‐Souza JP, Smith R, Benedet AL, Gauthier S, Hansson O, Rosa‐Neto P. Discriminative accuracy of the A/T/N scheme to identify cognitive impairment due to Alzheimer's disease. Alzheimers Dement (Amst) 2023; 15:e12390. [PMID: 36733847 PMCID: PMC9886860 DOI: 10.1002/dad2.12390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/09/2022] [Accepted: 11/29/2022] [Indexed: 02/03/2023]
Abstract
Introduction The optimal combination of amyloid-β/tau/neurodegeneration (A/T/N) biomarker profiles for the diagnosis of Alzheimer's disease (AD) dementia is unclear. Methods We examined the discriminative accuracy of A/T/N combinations assessed with neuroimaging biomarkers for the differentiation of AD from cognitively unimpaired (CU) elderly and non-AD neurodegenerative diseases in the TRIAD, BioFINDER-1 and BioFINDER-2 cohorts (total n = 832) using area under the receiver operating characteristic curves (AUC). Results For the diagnosis of AD dementia (vs. CU elderly), T biomarkers performed as well as the complete A/T/N system (AUC range: 0.90-0.99). A and T biomarkers in isolation performed as well as the complete A/T/N system in differentiating AD dementia from non-AD neurodegenerative diseases (AUC range; A biomarker: 0.84-1; T biomarker: 0.83-1). Discussion In diagnostic settings, the use of A or T neuroimaging biomarkers alone can reduce patient burden and medical costs compared with using their combination, without significantly compromising accuracy.
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Affiliation(s)
- Tharick A. Pascoal
- Department of PsychiatrySchool of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of NeurologySchool of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Translational Neuroimaging LaboratoryThe McGill University Research Centre for Studies in AgingDepartment of Neurology and NeurosurgeryFaculty of MedicineMcGill UniversityMontrealQuébecCanada
| | - Antoine Leuzy
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityLundSweden
| | - Joseph Therriault
- Translational Neuroimaging LaboratoryThe McGill University Research Centre for Studies in AgingDepartment of Neurology and NeurosurgeryFaculty of MedicineMcGill UniversityMontrealQuébecCanada
- Montreal Neurological InstituteMcGill UniversityMontrealQuébecCanada
| | - Mira Chamoun
- Translational Neuroimaging LaboratoryThe McGill University Research Centre for Studies in AgingDepartment of Neurology and NeurosurgeryFaculty of MedicineMcGill UniversityMontrealQuébecCanada
- Montreal Neurological InstituteMcGill UniversityMontrealQuébecCanada
| | - Firoza Lussier
- Department of PsychiatrySchool of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Translational Neuroimaging LaboratoryThe McGill University Research Centre for Studies in AgingDepartment of Neurology and NeurosurgeryFaculty of MedicineMcGill UniversityMontrealQuébecCanada
| | - Cecile Tissot
- Department of NeurologySchool of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityLundSweden
| | - Olof Strandberg
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityLundSweden
- Memory ClinicSkåne University HospitalLundSweden
| | - Sebastian Palmqvist
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityLundSweden
- Memory ClinicSkåne University HospitalLundSweden
| | - Erik Stomrud
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityLundSweden
- Memory ClinicSkåne University HospitalLundSweden
| | - Pamela C. L. Ferreira
- Department of PsychiatrySchool of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - João Pedro Ferrari‐Souza
- Department of PsychiatrySchool of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Graduate Program in Biological Sciences: BiochemistryUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazil
| | - Ruben Smith
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityLundSweden
- Memory ClinicSkåne University HospitalLundSweden
| | - Andrea Lessa Benedet
- Translational Neuroimaging LaboratoryThe McGill University Research Centre for Studies in AgingDepartment of Neurology and NeurosurgeryFaculty of MedicineMcGill UniversityMontrealQuébecCanada
- Montreal Neurological InstituteMcGill UniversityMontrealQuébecCanada
| | - Serge Gauthier
- Translational Neuroimaging LaboratoryThe McGill University Research Centre for Studies in AgingDepartment of Neurology and NeurosurgeryFaculty of MedicineMcGill UniversityMontrealQuébecCanada
| | - Oskar Hansson
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityLundSweden
- Memory ClinicSkåne University HospitalLundSweden
| | - Pedro Rosa‐Neto
- Translational Neuroimaging LaboratoryThe McGill University Research Centre for Studies in AgingDepartment of Neurology and NeurosurgeryFaculty of MedicineMcGill UniversityMontrealQuébecCanada
- Montreal Neurological InstituteMcGill UniversityMontrealQuébecCanada
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7
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Oliveira Hauer K, Pawlik D, Leuzy A, Janelidze S, Hall S, Hansson O, Smith R. Performance of [ 18F]RO948 PET, MRI and CSF neurofilament light in the differential diagnosis of progressive supranuclear palsy. Parkinsonism Relat Disord 2023; 106:105226. [PMID: 36442367 DOI: 10.1016/j.parkreldis.2022.11.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The diagnosis of progressive supranuclear palsy (PSP) is often challenging since PSP may clinically resemble other neurodegenerative disorders. Recently, the tau PET tracer [18F]RO948, a potential new biomarker for PSP, was developed. The aim of this study was to determine the ability of three different biomarkers, including [18F]RO948 PET, to distinguish PSP patients from healthy controls and from patients with α-synucleinopathies. METHODS Patients with PSP (n = 23), α-synucleinopathies (n = 47) and healthy controls (n = 61) were included from the BioFINDER-2 study. [18F]RO948 standardized uptake value ratios (SUVR), magnetic resonance imaging midbrain/pons ratio, and cerebrospinal fluid neurofilament light (NfL) levels were compared between diagnostic groups individually and in combination. RESULTS [18F]RO948 PET SUVR in the globus pallidus, NfL, and midbrain/pons area ratios were all able to differentiate PSP patients from controls and from patients with α-synucleinopathies ([18F]RO948 [mean ± SD]: controls 1.24 ± 0.22; PSP 1.47 ± 0.4; PD 1.18 ± 0.2; DLB 1.25 ± 0.24, p < 0.05), (NfL pg/mL [mean ± SD]: controls 1055 ± 569; PSP 2197 ± 1010; PD 1038 ± 416; DLB 1548 ± 687, p < 0.001) and (midbrain/pons ratio [mean ± SD]: controls 0.46 ± 0.07; PSP 0.34 ± 0.09; PD 0.43 ± 0.06; DLB 0.40 ± 0.07, p < 0.01). Receiver operating characteristic (ROC) analyses indicated that combining the three biomarkers resulted in the highest area under the ROC values (0.94 [0.88-1.00]) for separating controls from PSP and (0.92 [0.85-0.99]) for separating PSP from α-synucleinopathies. CONCLUSIONS All studied biomarkers could individually separate PSP from controls and α-synucleinopathies patients at a group level. The optimal prediction models included NfL and midbrain/pons ratio for separating controls from PSP and all three biomarkers for separating PSP from α-synucleinopathies.
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Affiliation(s)
- Kevin Oliveira Hauer
- Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Daria Pawlik
- Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Antoine Leuzy
- Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Shorena Janelidze
- Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Sara Hall
- Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Oskar Hansson
- Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Ruben Smith
- Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; Department of Neurology, Skåne University Hospital, Lund, Sweden.
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8
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Smith R, Cullen NC, Pichet Binette A, Leuzy A, Blennow K, Zetterberg H, Klein G, Borroni E, Ossenkoppele R, Janelidze S, Palmqvist S, Mattsson-Carlgren N, Stomrud E, Hansson O. Tau-PET is superior to phospho-tau when predicting cognitive decline in symptomatic AD patients. Alzheimers Dement 2022. [PMID: 36516028 DOI: 10.1002/alz.12875] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/15/2022] [Accepted: 10/21/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Biomarkers for the prediction of cognitive decline in patients with amnestic mild cognitive impairment (MCI) and amnestic mild dementia are needed for both clinical practice and clinical trials. METHODS We evaluated the ability of tau-PET (positron emission tomography), cortical atrophy on magnetic resonance imaging (MRI), baseline cognition, apolipoprotein E gene (APOE) status, plasma and cerebrospinal fluid (CSF) levels of phosphorylated tau-217, neurofilament light (NfL), and amyloid beta (Aβ)42/40 ratio (individually and in combination) to predict cognitive decline over 2 years in BioFINDER-2 and Alzheimer's Disease Neuroimaging Initiative (ADNI). RESULTS Baseline tau-PET and a composite baseline cognitive score were the strongest independent predictors of cognitive decline. Cortical thickness and NfL provided some additional information. Using a predictive algorithm to enrich patient selection in a theoretical clinical trial led to a significantly lower required sample size. DISCUSSION Models including baseline tau-PET and cognition consistently provided the best prediction of change in cognitive function over 2 years in patients with amnestic MCI or mild dementia.
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Affiliation(s)
- Ruben Smith
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Nicholas C Cullen
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden
| | - Alexa Pichet Binette
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden
| | - Antoine Leuzy
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK.,Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | | | | | - Rik Ossenkoppele
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Shorena Janelidze
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Erik Stomrud
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Oskar Hansson
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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9
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Leuzy A, Binette AP, Vogel JW, Klein G, Borroni E, Tonietto M, Strandberg O, Mattsson‐Carlgren N, Palmqvist S, Pontecorvo MJ, Stomrud E, Ossenkoppele R, Hansson O. Comparison of group‐level and individualized ROIs for predicting change in longitudinal tau‐PET in preclinical and prodromal AD. Alzheimers Dement 2022. [DOI: 10.1002/alz.063057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | - Jacob W Vogel
- Penn/CHOP Lifespan Brain Institute University of Pennsylvania Philadelphia PA USA
- Department of Psychiatry University of Pennsylvania Philadelphia PA USA
| | - Gregory Klein
- Pharma Research and Early Development, F. Hoffmann‐La Roche Ltd. Basel Switzerland
| | - Edilio Borroni
- Pharma Research and Early Development, F. Hoffmann‐La Roche Ltd. Basel Switzerland
| | - Matteo Tonietto
- Roche Pharma Research and Early Development, FHoffmann‐La RocheLtd Basel Switzerland
| | | | - Niklas Mattsson‐Carlgren
- Clinical Memory Research Unit Lund University Malmö Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
- Wallenberg Center for Molecular Medicine, Lund University Lund Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | | | - Erik Stomrud
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit Lund University Malmö Sweden
- VU University Medical Center, Neuroscience Campus Amsterdam Amsterdam Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
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10
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Groot C, Smith R, Stomrud E, Binette AP, Leuzy A, Wuestefeld A, Wisse LEM, Palmqvist S, Janelidze S, Strandberg O, Ossenkoppele R, Hansson O. A biomarker profile of elevated CSF p‐tau with normal tau PET is associated with increased tau accumulation rates on PET in early Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.063622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Colin Groot
- Clinical Memory Research Unit, Lund University Lund Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Erik Stomrud
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | | | - Antoine Leuzy
- Memory Clinic, Skåne University Hospital Lund Sweden
| | | | | | | | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Malmö SI Sweden
| | | | - Rik Ossenkoppele
- Lund University Lund Sweden
- Alzheimer Center Amsterdam, Department of Neurology Neuroscience, Vrije Universiteit Amsterdam UMC, Amsterdam Amsterdam Amsterdam Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
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11
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Groot C, Smith R, Stomrud E, Binette AP, Leuzy A, Wuestefeld A, Wisse LEM, Palmqvist S, Janelidze S, Strandberg O, Ossenkoppele R, Hansson O. A biomarker profile of elevated CSF p‐tau with normal tau PET is associated with increased tau accumulation rates on PET in early Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.065666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Colin Groot
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | | | - Antoine Leuzy
- Memory Clinic, Skåne University Hospital Lund Sweden
| | | | | | | | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University Malmö SI Sweden
| | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Clinical Memory Research Unit, Lund University, Sweden Lund Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
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12
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Leuzy A, Mattsson‐Carlgren N, Cullen N, Stomrud E, Palmqvist S, La Joie R, Iaccarino L, Zetterberg H, Rabinovici GD, Blennow K, Janelidze S, Hansson O. Robustness of CSF Aβ42/40 and Aβ42/P‐tau181 to detect AD related outcomes using fully automated immunoassays. Alzheimers Dement 2022. [DOI: 10.1002/alz.063107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Niklas Mattsson‐Carlgren
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
- Wallenberg Center for Molecular Medicine, Lund University Lund Sweden
| | | | - Erik Stomrud
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Renaud La Joie
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco San Francisco CA USA
| | - Leonardo Iaccarino
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco San Francisco CA USA
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- UK Dementia Research Institute at UCL London United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay Hong Kong
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology London United Kingdom
| | - Gil D. Rabinovici
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco San Francisco CA USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco San Francisco CA USA
- Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory Berkeley CA USA
- Helen Wills Neuroscience Institute, University of California Berkeley Berkeley CA USA
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg Mölndal Sweden
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
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13
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Groot C, Smith R, Stomrud E, Binette AP, Leuzy A, Wuestefeld A, Wisse LEM, Palmqvist S, Mattsson-Carlgren N, Janelidze S, Strandberg O, Ossenkoppele R, Hansson O. Phospho-tau with subthreshold tau-PET predicts increased tau accumulation rates in amyloid-positive individuals. Brain 2022; 146:1580-1591. [PMID: 36084009 PMCID: PMC10115173 DOI: 10.1093/brain/awac329] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Different tau biomarkers become abnormal at different stages of Alzheimer’s disease, with CSF phospho-tau typically becoming elevated at subthreshold levels of tau-PET binding. To capitalize on the temporal order of tau biomarker-abnormality and capture the earliest changes of tau accumulation, we implemented an observational study design to examine longitudinal changes in Tau-PET, cortical thickness and cognitive decline in amyloid-β-positive (A+) individuals with elevated CSF P-tau levels (P+) but subthreshold Tau-PET retention (T-). To this end, individuals without dementia (i.e., cognitively unimpaired or mild cognitive impairment, N = 231) were selected from the BioFINDER-2 study. Amyloid-β-positive (A+) individuals were categorized into biomarker groups based on cut-offs for abnormal CSF P-tau217 and [18F]RO948 (Tau) PET, yielding groups of tau-concordant-negative (A + P-T-; n = 30), tau-discordant (i.e., A + P+T-; n = 48) and tau-concordant-positive (A + P+T+; n = 18) individuals. In addition, 135 amyloid-β-negative, tau-negative, cognitively unimpaired individuals served as controls. Differences in annual change in regional Tau-PET, cortical thickness and cognition between the groups were assessed using general linear models, adjusted for age, sex, clinical diagnosis and (for cognitive measures only) education. Mean follow-up time was ∼2 years. Longitudinal increase in Tau-PET was faster in the A + P+T- group than in the control and A + P-T- groups across medial temporal and neocortical regions, with the highest accumulation rates in the medial temporal lobe. The A + P+T- group showed a slower rate of increases in tau-PET compared to the A + P+T+ group, primarily in neocortical regions. We did not detect differences in yearly change in cortical thickness or in cognitive decline between the A + P+T- and A + P-T- groups. The A + P+T+ group, however, showed faster cognitive decline compared to all other groups. Altogether, these findings suggest that the A + P+T- biomarker profile in persons without dementia is associated with an isolated effect on increased Tau-PET accumulation rates but not on cortical thinning and cognitive decline. While this suggests that the tau-discordant biomarker profile is not strongly associated with short-term clinical decline, this group does represent an interesting population for monitoring effects of interventions with disease modifying agents on tau accumulation in early Alzheimer’s disease, and for examining the emergence of tau aggregates in Alzheimer’s disease. Further, we suggest to update the AT(N) criteria for Alzheimer’s disease biomarker classification to APT(N).
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Affiliation(s)
- Colin Groot
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Alzheimer center, Amsterdam UMC location Vumc , Amsterdam , The Netherlands
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Department of Neurology, Skåne University Hospital, Lund University , Lund , Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Memory Clinic, Skåne University Hospital , Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
| | - Anika Wuestefeld
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
| | - Laura E M Wisse
- Department of Diagnostic Radiology, Lund University , Lund , Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Memory Clinic, Skåne University Hospital , Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Department of Neurology, Skåne University Hospital, Lund University , Lund , Sweden
- Wallenberg Center for Molecular Medicine, Lund University , Lund , Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Alzheimer center, Amsterdam UMC location Vumc , Amsterdam , The Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Memory Clinic, Skåne University Hospital , Sweden
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14
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Tideman P, Stomrud E, Leuzy A, Mattsson-Carlgren N, Palmqvist S, Hansson O. Association of β-Amyloid Accumulation With Executive Function in Adults With Unimpaired Cognition. Neurology 2022; 98:e1525-e1533. [PMID: 35022305 PMCID: PMC9012270 DOI: 10.1212/wnl.0000000000013299] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 12/27/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The neuropathologic changes underlying Alzheimer disease (AD) start before overt cognitive symptoms arise, but it is not well-known how they relate to the first subtle cognitive changes. The objective for this study was to examine the independent associations of the AD hallmarks β-amyloid (Aβ), tau, and neurodegeneration with different cognitive domains in cognitively unimpaired (CU) individuals. METHODS In this cross-sectional study, CU participants from the prospective BioFINDER-2 study were included. All had CSF biomarkers (Aβ42 and phosphorylated tau [p-tau]181), MRI (cortical thickness of AD-susceptible regions), Aβ-PET (neocortical uptake), tau-PET (entorhinal uptake), and cognitive test data for memory, executive function, verbal function, and visuospatial function. Multivariable linear regression models were performed using either CSF Aβ42, p-tau181, and cortical thickness or Aβ-PET, tau-PET, and cortical thickness as predictors of cognitive function. The results were validated in an independent cohort (Alzheimer's Disease Neuroimaging Initiative [ADNI]). RESULTS A total of 316 CU participants were included from the BioFINDER-2 study. Abnormal Aβ status was independently associated with the executive measure, regardless of modality (CSF Aβ42, β = 0.128, p = 0.024; Aβ-PET, β = 0.124, p = 0.049), while tau was independently associated with memory (CSF p-tau181, β = 0.132, p = 0.018; tau-PET, β = 0.189, p = 0.002). Cortical thickness was independently associated with the executive measure and verbal fluency in both models (p = 0.005-0.018). To examine the relationships in the earliest stage of preclinical AD, only participants with normal biomarkers of tau and neurodegeneration were included (n = 217 CSF-based; n = 246 PET-based). Again, Aβ status was associated with executive function (CSF Aβ42, β = 0.189, p = 0.005; Aβ-PET, β = 0.146, p = 0.023), but not with other cognitive domains. The results were overall replicated in the ADNI cohort (n = 361). DISCUSSION These findings suggest that Aβ is independently associated with worse performance on an executive measure but not with memory performance, which instead is associated with tau pathology. This may have implications for early preclinical AD screening and outcome measures in AD trials targeting Aβ pathology.
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Affiliation(s)
- Pontus Tideman
- From the Clinical Memory Research Unit, Department of Clinical Sciences (P.T., E.S., A.L., N.M.-C., S.P., O.H.), and Wallenberg Center for Molecular Medicine (N.M.-C.), Lund University; and Memory Clinic (P.T., E.S., S.P., O.H.) and Department of Neurology (N.M.-C.), Skåne University Hospital, Sweden
| | - Erik Stomrud
- From the Clinical Memory Research Unit, Department of Clinical Sciences (P.T., E.S., A.L., N.M.-C., S.P., O.H.), and Wallenberg Center for Molecular Medicine (N.M.-C.), Lund University; and Memory Clinic (P.T., E.S., S.P., O.H.) and Department of Neurology (N.M.-C.), Skåne University Hospital, Sweden
| | - Antoine Leuzy
- From the Clinical Memory Research Unit, Department of Clinical Sciences (P.T., E.S., A.L., N.M.-C., S.P., O.H.), and Wallenberg Center for Molecular Medicine (N.M.-C.), Lund University; and Memory Clinic (P.T., E.S., S.P., O.H.) and Department of Neurology (N.M.-C.), Skåne University Hospital, Sweden
| | - Niklas Mattsson-Carlgren
- From the Clinical Memory Research Unit, Department of Clinical Sciences (P.T., E.S., A.L., N.M.-C., S.P., O.H.), and Wallenberg Center for Molecular Medicine (N.M.-C.), Lund University; and Memory Clinic (P.T., E.S., S.P., O.H.) and Department of Neurology (N.M.-C.), Skåne University Hospital, Sweden
| | - Sebastian Palmqvist
- From the Clinical Memory Research Unit, Department of Clinical Sciences (P.T., E.S., A.L., N.M.-C., S.P., O.H.), and Wallenberg Center for Molecular Medicine (N.M.-C.), Lund University; and Memory Clinic (P.T., E.S., S.P., O.H.) and Department of Neurology (N.M.-C.), Skåne University Hospital, Sweden
| | - Oskar Hansson
- From the Clinical Memory Research Unit, Department of Clinical Sciences (P.T., E.S., A.L., N.M.-C., S.P., O.H.), and Wallenberg Center for Molecular Medicine (N.M.-C.), Lund University; and Memory Clinic (P.T., E.S., S.P., O.H.) and Department of Neurology (N.M.-C.), Skåne University Hospital, Sweden.
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15
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Janelidze S, Palmqvist S, Leuzy A, Stomrud E, Verberk IMW, Zetterberg H, Ashton NJ, Pesini P, Sarasa L, Allué JA, Teunissen CE, Dage JL, Blennow K, Mattsson-Carlgren N, Hansson O. Detecting amyloid positivity in early Alzheimer's disease using combinations of plasma Aβ42/Aβ40 and p-tau. Alzheimers Dement 2022; 18:283-293. [PMID: 34151519 DOI: 10.1002/alz.12395] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 01/20/2023]
Abstract
INTRODUCTION We studied usefulness of combining blood amyloid beta (Aβ)42/Aβ40, phosphorylated tau (p-tau)217, and neurofilament light (NfL) to detect abnormal brain Aβ deposition in different stages of early Alzheimer's disease (AD). METHODS Plasma biomarkers were measured using mass spectrometry (Aβ42/Aβ40) and immunoassays (p-tau217 and NfL) in cognitively unimpaired individuals (CU, N = 591) and patients with mild cognitive impairment (MCI, N = 304) from two independent cohorts (BioFINDER-1, BioFINDER-2). RESULTS In CU, a combination of plasma Aβ42/Aβ40 and p-tau217 detected abnormal brain Aβ status with area under the curve (AUC) of 0.83 to 0.86. In MCI, the models including p-tau217 alone or Aβ42/Aβ40 and p-tau217 had similar AUCs (0.86-0.88); however, the latter showed improved model fit. The models were implemented in an online application providing individualized risk assessments (https://brainapps.shinyapps.io/PredictABplasma/). DISCUSSION A combination of plasma Aβ42/Aβ40 and p-tau217 discriminated Aβ status with relatively high accuracy, whereas p-tau217 showed strongest associations with Aβ pathology in MCI but not in CU.
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Affiliation(s)
- Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Skåne University Hospital, Malmö, Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Skåne University Hospital, Malmö, Sweden
| | - Inge M W Verberk
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
| | | | | | | | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Skåne University Hospital, Malmö, Sweden
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16
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Leuzy A, Mattsson‐Carlgren N, Palmqvist S, Janelidze S, Dage JL, Hansson O. Blood-based biomarkers for Alzheimer's disease. EMBO Mol Med 2022; 14:e14408. [PMID: 34859598 PMCID: PMC8749476 DOI: 10.15252/emmm.202114408] [Citation(s) in RCA: 101] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 12/01/2022] Open
Abstract
Neurodegenerative disorders such as Alzheimer's disease (AD) represent a mounting public health challenge. As these diseases are difficult to diagnose clinically, biomarkers of underlying pathophysiology are playing an ever-increasing role in research, clinical trials, and in the clinical work-up of patients. Though cerebrospinal fluid (CSF) and positron emission tomography (PET)-based measures are available, their use is not widespread due to limitations, including high costs and perceived invasiveness. As a result of rapid advances in the development of ultra-sensitive assays, the levels of pathological brain- and AD-related proteins can now be measured in blood, with recent work showing promising results. Plasma P-tau appears to be the best candidate marker during symptomatic AD (i.e., prodromal AD and AD dementia) and preclinical AD when combined with Aβ42/Aβ40. Though not AD-specific, blood NfL appears promising for the detection of neurodegeneration and could potentially be used to detect the effects of disease-modifying therapies. This review provides an overview of the progress achieved thus far using AD blood-based biomarkers, highlighting key areas of application and unmet challenges.
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Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
| | - Niklas Mattsson‐Carlgren
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
- Department of NeurologySkåne University HospitalLundSweden
- Wallenberg Centre for Molecular MedicineLund UniversityLundSweden
| | - Sebastian Palmqvist
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
- Memory ClinicSkåne University HospitalLundSweden
| | - Shorena Janelidze
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
| | - Jeffrey L Dage
- Stark Neuroscience Research InstituteIndiana University School of MedicineIndianapolisINUSA
| | - Oskar Hansson
- Clinical Memory Research UnitDepartment of Clinical SciencesLund UniversityMalmöSweden
- Memory ClinicSkåne University HospitalLundSweden
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17
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Janelidze S, Palmqvist S, Leuzy A, Stomrud E, Verberk IM, Zetterberg H, Ashton NJ, Mattsson‐Carlgren N, Pesini P, Sarasa L, Allué JA, Teunissen CE, Dage JL, Blennow K, Hansson O. Detecting amyloid positivity in early Alzheimer disease using plasma biomarkers. Alzheimers Dement 2021. [DOI: 10.1002/alz.052117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Sebastian Palmqvist
- Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | | | - Erik Stomrud
- Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Inge M.W. Verberk
- Neurochemistry Laboratory, Department of Clinical Chemistry, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square London United Kingdom
- UK Dementia Research Institute Fluid Biomarkers Laboratory, UK DRI at UCL London United Kingdom
| | - Nicholas J. Ashton
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation London United Kingdom
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg Gothenburg Sweden
- King's College London London United Kingdom
- Institute of Physiology and Neuroscience, University of Gothenburg Mölndal Sweden
| | | | | | | | | | - Charlotte E. Teunissen
- Neurochemistry Lab, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC Amsterdam Amsterdam Netherlands
| | | | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg Mölndal Sweden
| | - Oskar Hansson
- Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
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18
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Leuzy A, Smith R, Cullen NC, Strandberg O, Vogel JW, Binette AP, Borroni E, Janelidze S, Ohlsson T, Jögi J, Ossenkoppele R, Palmqvist S, Mattsson-Carlgren N, Klein G, Stomrud E, Hansson O. Biomarker-Based Prediction of Longitudinal Tau Positron Emission Tomography in Alzheimer Disease. JAMA Neurol 2021; 79:149-158. [PMID: 34928318 PMCID: PMC8689441 DOI: 10.1001/jamaneurol.2021.4654] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Question Which biomarkers best predict longitudinal tau accumulation at different clinical stages of Alzheimer disease? Findings In this cohort study of 343 participants including amyloid-β–positive individuals who were cognitively unimpaired or had mild cognitive impairment, the largest annual increase in [18F]RO948 tau positron emission tomography (PET) was seen across the entorhinal cortex, hippocampus, and amygdala and in temporal cortical regions, respectively. In a power analysis, plasma phosphorylated tau217 with tau PET at baseline in stage I and II, respectively, resulted in sample size reductions. Meaning In trials using tau PET as a main outcome, plasma phosphorylated tau217 with tau PET may prove optimal for enrichment in both preclinical and prodromal Alzheimer disease. Importance There is currently no consensus as to which biomarkers best predict longitudinal tau accumulation at different clinical stages of Alzheimer disease (AD). Objective To describe longitudinal [18F]RO948 tau positron emission tomography (PET) findings across the clinical continuum of AD and determine which biomarker combinations showed the strongest associations with longitudinal tau PET and best optimized clinical trial enrichment. Design, Setting, and Participants This longitudinal cohort study consecutively enrolled amyloid-β (Aβ)–negative cognitively unimpaired (CU) participants, Aβ-positive CU individuals, Aβ-positive individuals with mild cognitive impairment (MCI), and individuals with AD dementia between September 2017 and November 2020 from the Swedish BioFINDER-2 (discovery cohort) and BioFINDER-1 (validation cohort) studies. Exposures Baseline plasma and cerebrospinal fluid Aβ42/Aβ40, tau phosphorylated at threonine-217 (p-tau217), p-tau181 and neurofilament light, magnetic resonance imaging, amyloid PET ([18F]flutemetamol), and tau PET ([18F]RO948 in the BioFINDER-2 study; [18F]flortaucipir in the BioFINDER-1 study). Main Outcomes and Measures Baseline tau PET standardized uptake value ratio (SUVR) and annual percent change in tau PET SUVR across regions of interest derived using a data-driven approach combining clustering and event-based modeling. Regression models were used to examine associations between individual biomarkers and longitudinal tau PET and to identify which combinations best predicted longitudinal tau PET. These combinations were then entered in a power analysis to examine how their use as an enrichment strategy would affect sample size in a simulated clinical trial. Results Of 343 participants, the mean (SD) age was 72.56 (7.24) years, and 157 (51.1%) were female. The clustering/event-based modeling–based approach identified 5 regions of interest (stages). In Aβ-positive CU individuals, the largest annual increase in tau PET SUVR was seen in stage I (entorhinal cortex, hippocampus, and amygdala; 4.04% [95% CI, 2.67%-5.32%]). In Aβ-positive individuals with MCI and with AD dementia, the greatest increases were seen in stages II (temporal cortical regions; 4.45% [95% CI, 3.41%-5.49%]) and IV (certain frontal regions; 5.22% [95% CI, 3.95%-6.49%]), respectively. In Aβ-negative CU individuals and those with MCI, modest change was seen in stage I (1.38% [95% CI, 0.78%-1.99%] and 1.80% [95% CI, 0.76%-2.84%], respectively). When looking at individual predictors and longitudinal tau PET in the stages that showed most change, plasma p-tau217 (R2 = 0.27, P < .005), tau PET (stage I baseline SUVR; R2 = 0.13, P < .05) and amyloid PET (R2 = 0.10, P < .05) were significantly associated with longitudinal tau PET in stage I in Aβ-positive CU individuals. In Aβ-positive individuals with MCI, plasma p-tau217 (R2 = 0.24, P < .005) and tau PET (stage II baseline SUVR; R2 = 0.44, P < .001) were significantly associated with longitudinal tau PET in stage II. Findings were replicated in BioFINDER-1 using longitudinal [18F]flortaucipir. For the power analysis component, plasma p-tau217 with tau PET resulted in sample size reductions of 43% (95% CI, 34%-46%; P < .005) in Aβ-positive CU individuals and of 68% (95% CI, 61%-73%; P < .001) in Aβ-positive individuals with MCI. Conclusions and Relevance In trials using tau PET as the outcome, plasma p-tau217 with tau PET may prove optimal for enrichment in preclinical and prodromal AD. However, plasma p-tau217 was most important in preclinical AD, while tau PET was more important in prodromal AD.
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Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Nicholas C Cullen
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Jacob W Vogel
- Penn/CHOP Lifespan Brain Institute, University of Pennsylvania, Philadelphia.,Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Tomas Ohlsson
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Jonas Jögi
- Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | | | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden
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Smith R, Cullen N, Leuzy A, Janelidze S, Palmqvist S, Dage JL, Borroni E, Klein G, Ossenkoppele R, Mattsson‐Carlgren N, Stomrud E, Hansson O. Ability of tau‐PET, phospho‐tau217, NfL and cortical thickness to predict short‐term cognitive decline in early symptomatic Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.053054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ruben Smith
- Lund University Lund Sweden
- Neurology Clinic Skåne University Hospital Lund Sweden
| | - Nicholas Cullen
- Clinical Memory Research Unit Department of Clinical Sciences, Malmö Lund University Lund Sweden
| | | | | | - Sebastian Palmqvist
- Clinical Memory Research Unit Lund University Malmö Sweden
- Memory Clinic Skåne University Hospital Malmö Sweden
| | | | | | | | - Rik Ossenkoppele
- Clinical Memory Research Unit Lund University Malmö Sweden
- Amsterdam University Medical Center Amsterdam Netherlands
| | - Niklas Mattsson‐Carlgren
- Lund University Lund Sweden
- Department of Clinical Sciences Lund, Neurology Lund University Skåne University Hospital Lund Sweden
- Wallenberg Center for Molecular Medicine Lund University Lund Sweden
| | | | - Oskar Hansson
- Lund University Lund Sweden
- Memory Clinic Skåne University Hospital Malmö Sweden
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20
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Leuzy A, Smith R, Cullen N, Strandberg O, Janelidze S, Ohlsson T, Jögi J, Borroni E, Klein G, Dage JL, Palmqvist S, Mattsson‐Carlgren N, Stomrud E, Hansson O. Biomarker driven enrichment strategies for tau pathology in AD clinical trials. Alzheimers Dement 2021. [DOI: 10.1002/alz.055656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
- Neurology Clinic Skåne University Hospital Lund Sweden
| | | | | | | | | | | | | | | | | | - Sebastian Palmqvist
- Clinical Memory Research Unit Lund University Malmö Sweden
- Memory Clinic Skåne University Hospital Malmö Sweden
| | - Niklas Mattsson‐Carlgren
- Clinical Memory Research Unit Lund University Malmö Sweden
- Neurology Clinic Skåne University Hospital Lund Sweden
- Wallenberg Center for Molecular Medicine Lund University Lund Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit Lund University Malmö Sweden
- Memory Clinic Skåne University Hospital Malmö Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
- Memory Clinic Skåne University Hospital Malmö Sweden
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21
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Dore V, Bohorquez SS, Leuzy A, Shimada H, Bullich S, Bourgeat P, Burnham SC, Huang K, Krishnadas N, Fripp J, Takado Y, Stephens AW, Weimer R, Rowe CC, Higuchi M, Hansson O, Villemagne VL. Towards a universal cortical tau sampling mask. Alzheimers Dement 2021. [DOI: 10.1002/alz.055816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Vincent Dore
- CSIRO Health and Biosecurity, Australian E‐Health Research Centre Brisbane QLD Australia
- Department of Molecular Imaging, Austin Health Melbourne VIC Australia
| | | | - Antoine Leuzy
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Hitoshi Shimada
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology Chiba Japan
- Brain Research Institute, Niigata University Niigata Japan
| | | | - Pierrick Bourgeat
- CSIRO Health and Biosecurity, Australian E‐Health Research Centre Brisbane QLD Australia
| | | | - Kun Huang
- Austin Health Melbourne VIC Australia
| | - Natasha Krishnadas
- Department of Molecular Imaging and Therapy, Austin Health Melbourne VIC Australia
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, Australian E‐Health Research Centre Brisbane QLD Australia
| | - Yuhei Takado
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology Chiba Japan
| | | | | | - Christopher C Rowe
- The University of Melbourne Melbourne VIC Australia
- Australian Dementia Network (ADNeT) Melbourne Australia
- Department of Molecular Imaging and Therapy, Austin Health Melbourne VIC Australia
| | - Makoto Higuchi
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology Chiba Japan
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Victor L Villemagne
- Departments of Medicine and Molecular Imaging, University of Melbourne, Austin Health Melbourne VIC Australia
- The University of Pittsburgh Pittsburgh PA USA
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22
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Leuzy A, Janelidze S, Mattsson‐Carlgren N, Palmqvist S, Jacobs D, Cicognola C, Stomrud E, Vanmechelen E, Dage JL, Hansson O. Comparing the clinical utility and diagnostic performance of cerebrospinal fluid P‐tau181, P‐tau217 and P‐tau231 assays. Alzheimers Dement 2021. [DOI: 10.1002/alz.055316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | | | - Niklas Mattsson‐Carlgren
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
- Wallenberg Center for Molecular Medicine, Lund University Lund Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | | | | | - Erik Stomrud
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | | | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
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23
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Leuzy A, Santillo A, Smith R, Groot C, Ossenkoppele R, Hansson O. [
18
F]RO948 tau PET in bvFTD due to
C9orf72
and
GRN
mutations. Alzheimers Dement 2021. [DOI: 10.1002/alz.055604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
- Neurology Clinic Skåne University Hospital Lund Sweden
| | - Colin Groot
- Alzheimer Center and Department of Neurology Amsterdam Neuroscience VU University Medical Center Amsterdam Netherlands
| | - Rik Ossenkoppele
- Clinical Memory Research Unit Lund University Malmö Sweden
- Alzheimer Center and Department of Neurology Amsterdam Neuroscience VU University Medical Center Amsterdam Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Lund Sweden
- Memory Clinic Skåne University Hospital Malmö Sweden
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Leuzy A, Janelidze S, Mattsson-Carlgren N, Palmqvist S, Jacobs D, Cicognola C, Stomrud E, Vanmechelen E, Dage JL, Hansson O. Comparing the Clinical Utility and Diagnostic Performance of CSF P-Tau181, P-Tau217, and P-Tau231 Assays. Neurology 2021; 97:e1681-e1694. [PMID: 34493616 PMCID: PMC8605616 DOI: 10.1212/wnl.0000000000012727] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 08/19/2021] [Indexed: 12/30/2022] Open
Abstract
Background and Objectives Phosphorylated tau (p-tau) in CSF is considered an important biomarker in Alzheimer disease (AD) and has been incorporated in recent diagnostic criteria. Several variants exist, including p-tau at threonines 181 (p-tau181), 217 (p-tau217), and 231 (p-tau231). However, no studies have compared their diagnostic performance or association to β-amyloid (Aβ) and tau-PET. Understanding which p-tau variant to use remains an important yet answered question. We aimed to compare the diagnostic accuracy of p-tau181, p-tau217, and p-tau231 in CSF for AD and their association with Aβ and tau-PET. Methods A total of 629 participants in the Swedish BioFINDER-2 study were included (cognitively unimpaired, n = 334; Aβ-positive mild cognitive impairment, n = 84; AD dementia, n = 119; and non-AD disorders, n = 92). In addition to p-tau181 and p-tau217 measured using assays with the same detector antibodies from Eli Lilly (p-tau181Lilly, p-tau217Lilly) and p-tau231, we also included p-tau181 measurements from 2 commonly used assays (Innotest and Elecsys). Results Although all p-tau variants increased across the AD continuum, p-tau217Lilly showed the greatest dynamic range (13-fold increase vs 1.9–5.4-fold increase for other p-tau variants for AD dementia vs non-AD). P-Tau217Lilly showed stronger correlations with Aβ- and tau-PET (p < 0.0001). P-Tau217Lilly exhibited higher accuracy than other p-tau variants for separating AD dementia from non-AD (area under the curve [AUC], 0.98 vs 0.88 [p < 0.0001] - 0.96 [p < 0.05]) and for identifying Aβ-PET (AUC, 0.86 vs 0.74 [p < 0.0001] and 0.83 [p < 0.001]) and tau-PET positivity (AUC, 0.94 vs 0.80—0.92, p < 0.0001). Finally, p-Tau181Lilly generally performed better than the other p-tau181 assays (e.g., AD dementia vs non-AD, AUC, 0.96 vs 0.88 [p-tau181Innotest] and 0.89 [p-tau181Elecsys]; p < 0.0001). Discussion CSF p-tau217Lilly seems to be more useful than other included p-tau assays in the workup of AD. Varied results across p-tau181 assays highlights the importance of anti-tau antibodies for biomarker performance. Classification of Evidence This study provides Class II evidence that p-tau217 provides higher diagnostic accuracy for diagnosis of AD dementia than p-tau181 or p-tau231.
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Affiliation(s)
- Antoine Leuzy
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN.
| | - Shorena Janelidze
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN
| | - Niklas Mattsson-Carlgren
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN
| | - Sebastian Palmqvist
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN
| | - Dirk Jacobs
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN
| | - Claudia Cicognola
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN
| | - Erik Stomrud
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN
| | - Eugeen Vanmechelen
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN
| | - Jeffrey L Dage
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN
| | - Oskar Hansson
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN.
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25
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Boccardi M, Dodich A, Albanese E, Gayet-Ageron A, Festari C, Ashton NJ, Bischof GN, Chiotis K, Leuzy A, Wolters EE, Walter M, Rabinovici GD, Carrillo M, Drzezga A, Hansson O, Nordberg A, Ossenkoppele R, Villemagne VL, Winblad B, Frisoni G, Garibotto V. Correction to: The Strategic Biomarker Roadmap for the validation of Alzheimer's diagnostic biomarkers: methodological update. Eur J Nucl Med Mol Imaging 2021; 48:4525-4531. [PMID: 34546388 DOI: 10.1007/s00259-021-05549-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marina Boccardi
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany. .,LANVIE, Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland.
| | - Alessandra Dodich
- Center for Neurocognitive Rehabilitation (CeRiN), CIMeC, University of Trento, Trento, Italy.,NIMTlab, Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
| | | | | | - Cristina Festari
- LANE, Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, United Kingdom.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Gérard N Bischof
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Konstantinos Chiotis
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Theme Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Antoine Leuzy
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Emma E Wolters
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Martin Walter
- Nuclear Medicine and Molecular Division, Geneva Medical Hospital, Geneva, Switzerland
| | - Gil D Rabinovici
- Departments of Neurology, Radiology & Biomedical Imaging, University of California, San Francisco, USA
| | | | - Alexander Drzezga
- University of Cologne, Faculty of Medicine, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany.,Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Research Center Jülich, Jülich, Germany
| | - Oskar Hansson
- Clinical Memory Rresearch Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Theme Aging, Geriatric Clinic, Huddinge, Sweden
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Clinical Memory Research, Lund University, Lund, Sweden
| | - Victor L Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, Melbourne, VIC, Australia.,Department of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Bengt Winblad
- Karolinska University Hospital, Theme Aging, Geriatric Clinic, Huddinge, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni Frisoni
- LANVIE, Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland.,Memory Clinic, University Hospital, Geneva, Switzerland
| | - Valentina Garibotto
- NIMTlab, Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland.,Nuclear Medicine and Molecular Division, Geneva Medical Hospital, Geneva, Switzerland
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26
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Ossenkoppele R, Smith R, Mattsson-Carlgren N, Groot C, Leuzy A, Strandberg O, Palmqvist S, Olsson T, Jögi J, Stormrud E, Cho H, Ryu YH, Choi JY, Boxer AL, Gorno-Tempini ML, Miller BL, Soleimani-Meigooni D, Iaccarino L, La Joie R, Baker S, Borroni E, Klein G, Pontecorvo MJ, Devous MD, Jagust WJ, Lyoo CH, Rabinovici GD, Hansson O. Accuracy of Tau Positron Emission Tomography as a Prognostic Marker in Preclinical and Prodromal Alzheimer Disease: A Head-to-Head Comparison Against Amyloid Positron Emission Tomography and Magnetic Resonance Imaging. JAMA Neurol 2021; 78:961-971. [PMID: 34180956 PMCID: PMC8240013 DOI: 10.1001/jamaneurol.2021.1858] [Citation(s) in RCA: 121] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Question What is the prognostic value of tau positron emission tomography (PET) for predicting cognitive decline across the clinical spectrum of Alzheimer disease? Findings In this longitudinal, multicenter prognostic study including 1431 participants, baseline tau PET predicted change in Mini-Mental State Examination scores during a mean (SD) follow-up of 1.9 (0.8) years. Moreover, tau PET outperformed established volumetric magnetic resonance imaging and amyloid PET markers in head-to-head comparisons, especially in participants with mild cognitive impairment and cognitively normal individuals who were positive for amyloid-β. Meaning These findings suggest that tau PET is a promising prognostic tool for predicting cognitive decline in preclinical and prodromal stages of Alzheimer disease. Importance Tau positron emission tomography (PET) tracers have proven useful for the differential diagnosis of dementia, but their utility for predicting cognitive change is unclear. Objective To examine the prognostic accuracy of baseline fluorine 18 (18F)–flortaucipir and [18F]RO948 (tau) PET in individuals across the Alzheimer disease (AD) clinical spectrum and to perform a head-to-head comparison against established magnetic resonance imaging (MRI) and amyloid PET markers. Design, Setting, and Participants This prognostic study collected data from 8 cohorts in South Korea, Sweden, and the US from June 1, 2014, to February 28, 2021, with a mean (SD) follow-up of 1.9 (0.8) years. A total of 1431 participants were recruited from memory clinics, clinical trials, or cohort studies; 673 were cognitively unimpaired (CU group; 253 [37.6%] positive for amyloid-β [Aβ]), 443 had mild cognitive impairment (MCI group; 271 [61.2%] positive for Aβ), and 315 had a clinical diagnosis of AD dementia (315 [100%] positive for Aβ). Exposures [18F]Flortaucipir PET in the discovery cohort (n = 1135) or [18F]RO948 PET in the replication cohort (n = 296), T1-weighted MRI (n = 1431), and amyloid PET (n = 1329) at baseline and repeated Mini-Mental State Examination (MMSE) evaluation. Main Outcomes and Measures Baseline [18F]flortaucipir/[18F]RO948 PET retention within a temporal region of interest, MRI-based AD-signature cortical thickness, and amyloid PET Centiloids were used to predict changes in MMSE using linear mixed-effects models adjusted for age, sex, education, and cohort. Mediation/interaction analyses tested whether associations between baseline tau PET and cognitive change were mediated by baseline MRI measures and whether age, sex, and APOE genotype modified these associations. Results Among 1431 participants, the mean (SD) age was 71.2 (8.8) years; 751 (52.5%) were male. Findings for [18F]flortaucipir PET predicted longitudinal changes in MMSE, and effect sizes were stronger than for AD-signature cortical thickness and amyloid PET across all participants (R2, 0.35 [tau PET] vs 0.24 [MRI] vs 0.17 [amyloid PET]; P < .001, bootstrapped for difference) in the Aβ-positive MCI group (R2, 0.25 [tau PET] vs 0.15 [MRI] vs 0.07 [amyloid PET]; P < .001, bootstrapped for difference) and in the Aβ-positive CU group (R2, 0.16 [tau PET] vs 0.08 [MRI] vs 0.08 [amyloid PET]; P < .001, bootstrapped for difference). These findings were replicated in the [18F]RO948 PET cohort. MRI mediated the association between [18F]flortaucipir PET and MMSE in the groups with AD dementia (33.4% [95% CI, 15.5%-60.0%] of the total effect) and Aβ-positive MCI (13.6% [95% CI, 0.0%-28.0%] of the total effect), but not the Aβ-positive CU group (3.7% [95% CI, −17.5% to 39.0%]; P = .71). Age (t = −2.28; P = .02), but not sex (t = 0.92; P = .36) or APOE genotype (t = 1.06; P = .29) modified the association between baseline [18F]flortaucipir PET and cognitive change, such that older individuals showed faster cognitive decline at similar tau PET levels. Conclusions and Relevance The findings of this prognostic study suggest that tau PET is a promising tool for predicting cognitive change that is superior to amyloid PET and MRI and may support the prognostic process in preclinical and prodromal stages of AD.
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Affiliation(s)
- Rik Ossenkoppele
- Clinical Memory Research Unit, Lund University, Malmö, Sweden.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Colin Groot
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Antoine Leuzy
- Clinical Memory Research Unit, Lund University, Malmö, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Lund University, Malmö, Sweden
| | | | - Tomas Olsson
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Jonas Jögi
- Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund, Sweden
| | - Erik Stormrud
- Clinical Memory Research Unit, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Division of Applied Radiological Imaging, Korea Institute Radiological and Medical Sciences, Seoul, South Korea
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco
| | - Maria L Gorno-Tempini
- Department of Neurology, Memory and Aging Center, University of California, San Francisco
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco
| | | | - Leonardo Iaccarino
- Department of Neurology, Memory and Aging Center, University of California, San Francisco
| | - Renaud La Joie
- Department of Neurology, Memory and Aging Center, University of California, San Francisco
| | - Suzanne Baker
- Lawrence Berkeley National Laboratory, Berkeley, California
| | | | | | | | | | - William J Jagust
- Lawrence Berkeley National Laboratory, Berkeley, California.,Helen Wills Neuroscience Institute, University of California, Berkeley
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, University of California, San Francisco.,Department of Radiology and Biomedical Imaging, University of California, San Francisco.,Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, California.,Associate Editor, JAMA Neurology
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Ossenkoppele R, Reimand J, Smith R, Leuzy A, Strandberg O, Palmqvist S, Stomrud E, Zetterberg H, Scheltens P, Dage JL, Bouwman F, Blennow K, Mattsson-Carlgren N, Janelidze S, Hansson O. Tau PET correlates with different Alzheimer's disease-related features compared to CSF and plasma p-tau biomarkers. EMBO Mol Med 2021; 13:e14398. [PMID: 34254442 PMCID: PMC8350902 DOI: 10.15252/emmm.202114398] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
PET, CSF and plasma biomarkers of tau pathology may be differentially associated with Alzheimer's disease (AD)‐related demographic, cognitive, genetic and neuroimaging markers. We examined 771 participants with normal cognition, mild cognitive impairment or dementia from BioFINDER‐2 (n = 400) and ADNI (n = 371). All had tau‐PET ([18F]RO948 in BioFINDER‐2, [18F]flortaucipir in ADNI) and CSF p‐tau181 biomarkers available. Plasma p‐tau181 and plasma/CSF p‐tau217 were available in BioFINDER‐2 only. Concordance between PET, CSF and plasma tau biomarkers ranged between 66 and 95%. Across the whole group, ridge regression models showed that increased CSF and plasma p‐tau181 and p‐tau217 levels were independently of tau PET associated with higher age, and APOEɛ4‐carriership and Aβ‐positivity, while increased tau‐PET signal in the temporal cortex was associated with worse cognitive performance and reduced cortical thickness. We conclude that biofluid and neuroimaging markers of tau pathology convey partly independent information, with CSF and plasma p‐tau181 and p‐tau217 levels being more tightly linked with early markers of AD (especially Aβ‐pathology), while tau‐PET shows the strongest associations with cognitive and neurodegenerative markers of disease progression.
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Affiliation(s)
- Rik Ossenkoppele
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Juhan Reimand
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.,Radiology Centre, North Estonia Medical Centre, Tallinn, Estonia
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | | | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Femke Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Leuzy A, Pascoal TA, Strandberg O, Insel P, Smith R, Mattsson-Carlgren N, Benedet AL, Cho H, Lyoo CH, La Joie R, Rabinovici GD, Ossenkoppele R, Rosa-Neto P, Hansson O. A multicenter comparison of [ 18F]flortaucipir, [ 18F]RO948, and [ 18F]MK6240 tau PET tracers to detect a common target ROI for differential diagnosis. Eur J Nucl Med Mol Imaging 2021; 48:2295-2305. [PMID: 34041562 PMCID: PMC8175317 DOI: 10.1007/s00259-021-05401-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 05/03/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE This study aims to determine whether comparable target regions of interest (ROIs) and cut-offs can be used across [18F]flortaucipir, [18F]RO948, and [18F]MK6240 tau positron emission tomography (PET) tracers for differential diagnosis of Alzheimer's disease (AD) dementia vs either cognitively unimpaired (CU) individuals or non-AD neurodegenerative diseases. METHODS A total of 1755 participants underwent tau PET using either [18F]flortaucipir (n = 975), [18F]RO948 (n = 493), or [18F]MK6240 (n = 287). SUVR values were calculated across four theory-driven ROIs and several tracer-specific data-driven (hierarchical clustering) regions of interest (ROIs). Diagnostic performance and cut-offs for ROIs were determined using receiver operating characteristic analyses and the Youden index, respectively. RESULTS Comparable diagnostic performance (area under the receiver operating characteristic curve [AUC]) was observed between theory- and data-driven ROIs. The theory-defined temporal meta-ROI generally performed very well for all three tracers (AUCs: 0.926-0.996). An SUVR value of approximately 1.35 was a common threshold when using this ROI. CONCLUSION The temporal meta-ROI can be used for differential diagnosis of dementia patients with [18F]flortaucipir, [18F]RO948, and [18F]MK6240 tau PET with high accuracy, and that using very similar cut-offs of around 1.35 SUVR. This ROI/SUVR cut-off can also be applied across tracers to define tau positivity.
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Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
| | - Tharick A Pascoal
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
- Department of Psychiatry and Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Philip Insel
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
- Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Andréa L Benedet
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
- CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil
| | - Hannah Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chul H Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Departments of Neurology, Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
- Memory Clinic, Skåne University Hospital, Lund, Sweden.
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Ashton NJ, Leuzy A, Karikari TK, Mattsson-Carlgren N, Dodich A, Boccardi M, Corre J, Drzezga A, Nordberg A, Ossenkoppele R, Zetterberg H, Blennow K, Frisoni GB, Garibotto V, Hansson O. The validation status of blood biomarkers of amyloid and phospho-tau assessed with the 5-phase development framework for AD biomarkers. Eur J Nucl Med Mol Imaging 2021; 48:2140-2156. [PMID: 33677733 PMCID: PMC8175325 DOI: 10.1007/s00259-021-05253-y] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/09/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE The development of blood biomarkers that reflect Alzheimer's disease (AD) pathophysiology (phosphorylated tau and amyloid-β) has offered potential as scalable tests for dementia differential diagnosis and early detection. In 2019, the Geneva AD Biomarker Roadmap Initiative included blood biomarkers in the systematic validation of AD biomarkers. METHODS A panel of experts convened in November 2019 at a two-day workshop in Geneva. The level of maturity (fully achieved, partly achieved, preliminary evidence, not achieved, unsuccessful) of blood biomarkers was assessed based on the Biomarker Roadmap methodology and discussed fully during the workshop which also evaluated cerebrospinal fluid (CSF) and positron emission tomography (PET) biomarkers. RESULTS Plasma p-tau has shown analytical validity (phase 2 primary aim 1) and first evidence of clinical validity (phase 3 primary aim 1), whereas the maturity level for Aβ remains to be partially achieved. Full and partial achievement has been assigned to p-tau and Aβ, respectively, in their associations to ante-mortem measures (phase 2 secondary aim 2). However, only preliminary evidence exists for the influence of covariates, assay comparison and cut-off criteria. CONCLUSIONS Despite the relative infancy of blood biomarkers, in comparison to CSF biomarkers, much has already been achieved for phases 1 through 3 - with p-tau having greater success in detecting AD and predicting disease progression. However, sufficient data about the effect of covariates on the biomarker measurement is lacking. No phase 4 (real-world performance) or phase 5 (assessment of impact/cost) aim has been tested, thus not achieved.
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Affiliation(s)
- N J Ashton
- Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, Sahlgrenska Academy, University of Gothenburg, House V3/SU, SE-431 80, Mölndal, Sweden.
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - A Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - T K Karikari
- Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, Sahlgrenska Academy, University of Gothenburg, House V3/SU, SE-431 80, Mölndal, Sweden
| | - N Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
- Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - A Dodich
- NIMTlab - Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
- Center for Neurocognitive Rehabilitation (CeRiN), CIMeC, University of Trento, Trento, Italy
| | - M Boccardi
- German Center for Neurodegenerative Diseases (DZNE), Rostock-Greifswald, Rostock, Germany
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
| | - J Corre
- Centre National de la Recherche Scientifique, Montpellier, France
| | - A Drzezga
- Medical Faculty and University Hospital of Cologne, Cologne, Germany
| | - A Nordberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Aging, Karolinska University Hospital Stockholm, Stockholm, Sweden
| | - R Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - H Zetterberg
- Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, Sahlgrenska Academy, University of Gothenburg, House V3/SU, SE-431 80, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - K Blennow
- Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, Sahlgrenska Academy, University of Gothenburg, House V3/SU, SE-431 80, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - G B Frisoni
- German Center for Neurodegenerative Diseases (DZNE), Rostock-Greifswald, Rostock, Germany
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - V Garibotto
- NIMTlab - Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
- Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland
| | - O Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.
- UK Dementia Research Institute at UCL, London, UK.
- Memory Clinic, Skåne University Hospital, SE-205 02, Malmö, Sweden.
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Ossenkoppele R, Leuzy A, Cho H, Sudre CH, Strandberg O, Smith R, Palmqvist S, Mattsson-Carlgren N, Olsson T, Jögi J, Stormrud E, Ryu YH, Choi JY, Boxer AL, Gorno-Tempini ML, Miller BL, Soleimani-Meigooni D, Iaccarino L, La Joie R, Borroni E, Klein G, Pontecorvo MJ, Devous MD, Villeneuve S, Lyoo CH, Rabinovici GD, Hansson O. The impact of demographic, clinical, genetic, and imaging variables on tau PET status. Eur J Nucl Med Mol Imaging 2021; 48:2245-2258. [PMID: 33215319 PMCID: PMC8131404 DOI: 10.1007/s00259-020-05099-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE A substantial proportion of amyloid-β (Aβ)+ patients with clinically diagnosed Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI) are tau PET-negative, while some clinically diagnosed non-AD neurodegenerative disorder (non-AD) patients or cognitively unimpaired (CU) subjects are tau PET-positive. We investigated which demographic, clinical, genetic, and imaging variables contributed to tau PET status. METHODS We included 2338 participants (430 Aβ+ AD dementia, 381 Aβ+ MCI, 370 non-AD, and 1157 CU) who underwent [18F]flortaucipir (n = 1944) or [18F]RO948 (n = 719) PET. Tau PET positivity was determined in the entorhinal cortex, temporal meta-ROI, and Braak V-VI regions using previously established cutoffs. We performed bivariate binary logistic regression models with tau PET status (positive/negative) as dependent variable and age, sex, APOEε4, Aβ status (only in CU and non-AD analyses), MMSE, global white matter hyperintensities (WMH), and AD-signature cortical thickness as predictors. Additionally, we performed multivariable binary logistic regression models to account for all other predictors in the same model. RESULTS Tau PET positivity in the temporal meta-ROI was 88.6% for AD dementia, 46.5% for MCI, 9.5% for non-AD, and 6.1% for CU. Among Aβ+ participants with AD dementia and MCI, lower age, MMSE score, and AD-signature cortical thickness showed the strongest associations with tau PET positivity. In non-AD and CU participants, presence of Aβ was the strongest predictor of a positive tau PET scan. CONCLUSION We identified several demographic, clinical, and neurobiological factors that are important to explain the variance in tau PET retention observed across the AD pathological continuum, non-AD neurodegenerative disorders, and cognitively unimpaired persons.
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Affiliation(s)
- Rik Ossenkoppele
- Clinical Memory Research Unit, Lund University, Lund, Sweden.
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, VU University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Antoine Leuzy
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Carole H Sudre
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Centre for Medical Image Computing, Department of Medical Physics, University College London, London, UK
| | - Olof Strandberg
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | | | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
- Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Tomas Olsson
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Jonas Jögi
- Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund, Sweden
| | - Erik Stormrud
- Clinical Memory Research Unit, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Division of applied RI, Korea Institute Radiological and Medical Sciences, Seoul, South Korea
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | - Maria L Gorno-Tempini
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | - David Soleimani-Meigooni
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | - Leonardo Iaccarino
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | - Renaud La Joie
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, USA
| | | | | | | | | | - Sylvia Villeneuve
- Departments of Psychiatry and Neurology & Neurosurgery, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Gil D Rabinovici
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
- Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Simrén J, Leuzy A, Karikari TK, Hye A, Benedet AL, Lantero‐Rodriguez J, Mattsson‐Carlgren N, Schöll M, Mecocci P, Vellas B, Tsolaki M, Kloszewska I, Soininen H, Lovestone S, Aarsland D, Hansson O, Rosa‐Neto P, Westman E, Blennow K, Zetterberg H, Ashton NJ. The diagnostic and prognostic capabilities of plasma biomarkers in Alzheimer's disease. Alzheimers Dement 2021; 17:1145-1156. [PMID: 33491853 PMCID: PMC8359457 DOI: 10.1002/alz.12283] [Citation(s) in RCA: 157] [Impact Index Per Article: 52.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/28/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study investigated the diagnostic and disease-monitoring potential of plasma biomarkers in mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia and cognitively unimpaired (CU) individuals. METHODS Plasma was analyzed using Simoa assays from 99 CU, 107 MCI, and 103 AD dementia participants. RESULTS Phosphorylated-tau181 (P-tau181), neurofilament light, amyloid-β (Aβ42/40), Total-tau and Glial fibrillary acidic protein were altered in AD dementia but P-tau181 significantly outperformed all biomarkers in differentiating AD dementia from CU (area under the curve [AUC] = 0.91). P-tau181 was increased in MCI converters compared to non-converters. Higher P-tau181 was associated with steeper cognitive decline and gray matter loss in temporal regions. Longitudinal change of P-tau181 was strongly associated with gray matter loss in the full sample and with Aβ measures in CU individuals. DISCUSSION P-tau181 detected AD at MCI and dementia stages and was strongly associated with cognitive decline and gray matter loss. These findings highlight the potential value of plasma P-tau181 as a non-invasive and cost-effective diagnostic and prognostic biomarker in AD.
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Affiliation(s)
- Joel Simrén
- Department of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalGothenburgSweden
| | - Antoine Leuzy
- Clinical Memory Research UnitLund UniversityMalmöSweden
| | - Thomas K. Karikari
- Department of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
| | - Abdul Hye
- Department of Old Age PsychiatryInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | | | - Juan Lantero‐Rodriguez
- Department of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
| | - Niklas Mattsson‐Carlgren
- Clinical Memory Research UnitLund UniversityMalmöSweden
- Department of NeurologySkåne University HospitalLundSweden
- Wallenberg Centre for Molecular MedicineLund UniversityLundSweden
| | - Michael Schöll
- Department of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Wallenberg Centre for Molecular and Translational MedicineUniversity of GothenburgGothenburgSweden
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
| | - Patrizia Mecocci
- Department of MedicineInstitute of Gerontology and GeriatricsUniversity of PerugiaPerugiaItaly
| | | | - Magda Tsolaki
- Aristotle University of ThessalonikiThessalonikiGreece
| | | | - Hilkka Soininen
- Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
| | | | - Dag Aarsland
- Department of Old Age PsychiatryInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
- Centre for Age‐Related MedicineStavanger University HospitalStavangerNorway
| | | | - Oskar Hansson
- Clinical Memory Research UnitLund UniversityMalmöSweden
- Memory ClinicSkåne University HospitalMalmöSweden
| | - Pedro Rosa‐Neto
- Translational Neuroimaging LaboratoryMcGill UniversityMontréalCanada
| | - Eric Westman
- Division of Clinical GeriatricsDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstituteStockholmSweden
- Department of NeuroimagingCentre for Neuroimaging SciencesPsychology and NeuroscienceKing's College LondonInstitute of PsychiatryLondonUK
| | - Kaj Blennow
- Department of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalGothenburgSweden
| | - Henrik Zetterberg
- Department of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalGothenburgSweden
- Department of Neurodegenerative DiseaseUCL Queen Square Institute of NeurologyLondonUK
- UK Dementia Research Institute at UCLLondonUK
| | - Nicholas J. Ashton
- Department of Psychiatry and NeurochemistryThe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Department of Old Age PsychiatryInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
- Wallenberg Centre for Molecular and Translational MedicineUniversity of GothenburgGothenburgSweden
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Cullen NC, Leuzy A, Janelidze S, Palmqvist S, Svenningsson AL, Stomrud E, Dage JL, Mattsson-Carlgren N, Hansson O. Plasma biomarkers of Alzheimer's disease improve prediction of cognitive decline in cognitively unimpaired elderly populations. Nat Commun 2021; 12:3555. [PMID: 34117234 PMCID: PMC8196018 DOI: 10.1038/s41467-021-23746-0] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/10/2021] [Indexed: 12/12/2022] Open
Abstract
Plasma biomarkers of amyloid, tau, and neurodegeneration (ATN) need to be characterized in cognitively unimpaired (CU) elderly individuals. We therefore tested if plasma measurements of amyloid-β (Aβ)42/40, phospho-tau217 (P-tau217), and neurofilament light (NfL) together predict clinical deterioration in 435 CU individuals followed for an average of 4.8 ± 1.7 years in the BioFINDER study. A combination of all three plasma biomarkers and basic demographics best predicted change in cognition (Pre-Alzheimer's Clinical Composite; R2 = 0.14, 95% CI [0.12-0.17]; P < 0.0001) and subsequent AD dementia (AUC = 0.82, 95% CI [0.77-0.91], P < 0.0001). In a simulated clinical trial, a screening algorithm combining all three plasma biomarkers would reduce the required sample size by 70% (95% CI [54-81]; P < 0.001) with cognition as trial endpoint, and by 63% (95% CI [53-70], P < 0.001) with subsequent AD dementia as trial endpoint. Plasma ATN biomarkers show usefulness in cognitively unimpaired populations and could make large clinical trials more feasible and cost-effective.
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Affiliation(s)
| | - Antoine Leuzy
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | | | - Sebastian Palmqvist
- Clinical Memory Research Unit, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Anna L Svenningsson
- Clinical Memory Research Unit, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | | | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Lund University, Lund, Sweden.
- Department of Neurology, Skåne University Hospital, Lund, Sweden.
- Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden.
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Lund, Sweden.
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Smith R, Strandberg O, Leuzy A, Betthauser TJ, Johnson SC, Pereira JB, Hansson O. Sex differences in off-target binding using tau positron emission tomography. Neuroimage Clin 2021; 31:102708. [PMID: 34091353 PMCID: PMC8182304 DOI: 10.1016/j.nicl.2021.102708] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 05/24/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE Off-target binding in the skull and meninges is observed in some subjects undergoing tau positron emission tomography (PET) and could potentially differ between men and women. In this study we elucidate sex differences in tau off-target binding using three different tau PET tracers. METHODS 541 cognitively unimpaired amyloid-β negative participants underwent tau PET using [18F]flortaucipir (n = 165), [18F]RO948 (n = 189) and [18F]MK6240 (n = 187). Baseline SUVR-values were compared between females and males at the voxel level and using a region-of-interest (ROI) encompassing the skull/meninges. In addition, we assessed the cross-sectional relationship between baseline skull/meninges SUVR and age and assessed change in skull/meningeal SUVR values over time in a subsample with longitudinal data (n = 63). RESULTS Voxel-wise analysis showed higher meningeal off-target binding in women compared to men across all three tracers. The SUVRs in the skull/meningeal ROI were highest using [18F]RO948, followed by [18F]MK6240 and [18F]flortaucipir (p < 0.001). For all tracers, females showed higher skull/meningeal ROI retention (mean SUVR ± SD [18F]flortaucipir: 0.82 ± 0.14; [18F]RO948: 1.26 ± 0.30; [18F]MK6240: 1.09 ± 0.19) compared to men ([18F]flortaucipir: 0.70 ± 0.11; [18F]RO948: 1.10 ± 0.24; [18F]MK6240: 0.97 ± 0.17) (p < 0.001). For [18F]flortaucipir and [18F]RO948, off-target binding in the skull/meninges decreased with age. CONCLUSION There is an effect of sex on off-target retention in the meninges/skull across [18F]flortaucipir, [18F]RO948, and [18F]MK6240 tau PET tracers.
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Affiliation(s)
- Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; Department of Neurology, Skåne University Hospital, Lund, Sweden.
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Tobey J Betthauser
- Alzheimer's Disease Research Center, Department of Medicine, Division of Geriatrics, University of Wisconsin, Madison, WI, USA
| | - Sterling C Johnson
- Alzheimer's Disease Research Center, Department of Medicine, Division of Geriatrics, University of Wisconsin, Madison, WI, USA; Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison WI, USA
| | - Joana B Pereira
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Singleton E, Hansson O, Pijnenburg YAL, La Joie R, Mantyh WG, Tideman P, Stomrud E, Leuzy A, Johansson M, Strandberg O, Smith R, Berendrecht E, Miller BL, Iaccarino L, Edwards L, Strom A, Wolters EE, Coomans E, Visser D, Golla SSV, Tuncel H, Bouwman F, Van Swieten JC, Papma JM, van Berckel B, Scheltens P, Dijkstra AA, Rabinovici GD, Ossenkoppele R. Heterogeneous distribution of tau pathology in the behavioural variant of Alzheimer's disease. J Neurol Neurosurg Psychiatry 2021; 92:jnnp-2020-325497. [PMID: 33850001 PMCID: PMC8292599 DOI: 10.1136/jnnp-2020-325497] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/16/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The clinical phenotype of the rare behavioural variant of Alzheimer's disease (bvAD) is insufficiently understood. Given the strong clinico-anatomical correlations of tau pathology in AD, we investigated the distribution of tau deposits in bvAD, in-vivo and ex-vivo, using positron emission tomography (PET) and postmortem examination. METHODS For the tau PET study, seven amyloid-β positive bvAD patients underwent [18F]flortaucipir or [18F]RO948 PET. We converted tau PET uptake values into standardised (W-)scores, adjusting for age, sex and mini mental state examination in a 'typical' memory-predominant AD (n=205) group. W-scores were computed within entorhinal, temporoparietal, medial and lateral prefrontal, insular and whole-brain regions-of-interest, frontal-to-entorhinal and frontal-to-parietal ratios and within intrinsic functional connectivity network templates. For the postmortem study, the percentage of AT8 (tau)-positive area in hippocampus CA1, temporal, parietal, frontal and insular cortices were compared between autopsy-confirmed patients with bvAD (n=8) and typical AD (tAD;n=7). RESULTS Individual regional W-scores ≥1.96 (corresponding to p<0.05) were observed in three cases, that is, case #5: medial prefrontal cortex (W=2.13) and anterior default mode network (W=3.79), case #2: lateral prefrontal cortex (W=2.79) and salience network (W=2.77), and case #7: frontal-to-entorhinal ratio (W=2.04). The remaining four cases fell within the normal distributions of the tAD group. Postmortem AT8 staining indicated no group-level regional differences in phosphorylated tau levels between bvAD and tAD (all p>0.05). CONCLUSIONS Both in-vivo and ex-vivo, patients with bvAD showed heterogeneous distributions of tau pathology. Since key regions involved in behavioural regulation were not consistently disproportionally affected by tau pathology, other factors are more likely driving the clinical phenotype in bvAD.
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Affiliation(s)
- Ellen Singleton
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - William G Mantyh
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Pontus Tideman
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital Lund, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital Lund, Lund, Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Maurits Johansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Evi Berendrecht
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
- In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Amelia Strom
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Emma E Wolters
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Emma Coomans
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Denise Visser
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Sandeep S V Golla
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Hayel Tuncel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Femke Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Janne M Papma
- Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bart van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Anke A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
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Abstract
PURPOSE OF REVIEW This review provides a concise overview of recent advances in cerebrospinal fluid (CSF) and blood-based biomarkers of Alzheimer's disease lesions. RECENT FINDINGS Important recent advances for CSF Alzheimer's disease biomarkers include the introduction of fully automated assays, the development and implementation of certified reference materials for CSF Aβ42 and a unified protocol for handling of samples, which all support reliability and availability of CSF Alzheimer's disease biomarkers. Aβ deposition can be detected using Aβ42/Aβ40 ratio in both CSF and plasma, though a much more modest change is seen in plasma. Tau aggregation can be detected using phosphorylated tau (P-tau) at threonine 181 and 217 in CSF, with similar accuracy in plasma. Neurofilament light (NfL) be measured in CSF and shows similar diagnostic accuracy in plasma. Though total tau (T-tau) can also be measured in plasma, this measure is of limited clinical relevance for Alzheimer's disease in its current immunoassay format. SUMMARY Alzheimer's disease biomarkers, including Aβ, P-tau and NfL can now be reliably measured in both CSF and blood. Plasma-based measures of P-tau show particular promise, with potential applications in both clinical practice and in clinical trials.
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Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö
| | - Nicholas C Cullen
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö
- Department of Neurology, Skåne University Hospital
- Wallenberg Centre for Molecular Medicine, Lund University
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö
- Memory Clinic, Skåne University Hospital, Lund, Sweden
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36
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Leuzy A, Smith R, Ossenkoppele R, Santillo A, Borroni E, Klein G, Ohlsson T, Jögi J, Palmqvist S, Mattsson-Carlgren N, Strandberg O, Stomrud E, Hansson O. Diagnostic Performance of RO948 F 18 Tau Positron Emission Tomography in the Differentiation of Alzheimer Disease From Other Neurodegenerative Disorders. JAMA Neurol 2021; 77:955-965. [PMID: 32391858 PMCID: PMC7215644 DOI: 10.1001/jamaneurol.2020.0989] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Question How does RO948 F 18 positron emission tomographic scanning discriminate between Alzheimer disease and other neurodegenerative disorders in comparison with magnetic resonance imaging and cerebrospinal fluid measures? Findings In this diagnostic study including 613 patients from the Swedish BioFINDER-2 clinical trial, standard uptake value ratios of RO948 F 18 were higher in patients with Alzheimer disease dementia compared with cognitively unimpaired controls and patients with other neurodegenerative disorders; furthermore, RO948 F 18 outperformed magnetic resonance imaging and cerebrospinal fluid measures. Generally, tau positron emission tomographic positivity was confined to amyloid β–positive cases or MAPT R406W mutation carriers in this cohort; in patients with semantic variant primary progressive aphasia, RO948 F 18 retention was lower than that for flortaucipir F 18. Meaning These findings suggest that RO948 F 18 has a high specificity for Alzheimer disease–type tau and highlight its potential as a diagnostic marker in the workup of patients treated in memory clinics. Importance The diagnostic performance of second-generation tau positron emission tomographic (PET) tracers is not yet known. Objective To examine the novel tau PET tracer RO948 F 18 ([18F]RO948) performance in discriminating Alzheimer disease (AD) from non-AD neurodegenerative disorders. Design, Setting, and Participants In this diagnostic study, 613 participants in the Swedish BioFINDER-2 study were consecutively enrolled in a prospective cross-sectional study from September 4, 2017, to August 28, 2019. Participants included 257 cognitively unimpaired controls, 154 patients with mild cognitive impairment, 100 patients with AD dementia, and 102 with non-AD neurodegenerative disorders. Evaluation included a comparison of tau PET tracer [18F]RO948 with magnetic resonance imaging (MRI) and cerebrospinal fluid and a head-to-head comparison between [18F]RO948 and flortaucipir F 18 ([18F]flortaucipir) in patients with semantic variant primary progressive aphasia (svPPA). Exposures [18F]RO948 (all patients) and [18F]flortaucipir (3 patients with svPPA) tau PET; MRI (hippocampal volume, composite temporal lobe cortical thickness, whole-brain cortical thickness) and cerebrospinal fluid measures (p-tau181 and amyloid Aβ42 and Aβ40 ratio[Aβ42/Aβ40], and Aβ42/p-tau181 ratio). Main Outcomes and Measures Standard uptake value ratios (SUVRs) in 4 predefined regions of interest (ROIs) reflecting Braak staging scheme for tau pathology and encompass I-II (entorhinal cortex), III-IV (inferior/middle temporal, fusiform gyrus, parahippocampal cortex, and amygdala), I-IV, and V-VI (widespread neocortical areas), area under the receiver operating characteristic curve (AUC) values, and subtraction images between [18F]RO948 and [18F]flortaucipir. Results Diagnostic groups among the 613 participants included cognitively unimpaired (mean [SD] age, 65.8 [12.1] years; 117 men [46%]), mild cognitive impairment (age, 70.8 [8.3] years; 82 men [53%]), AD dementia (age, 73.5 [6.7] years; 57 men [57%]), and non-AD disorders (age, 70.5 [8.6] years; 41 men [40%]). Retention of [18F]RO948 was higher in AD dementia compared with all other diagnostic groups. [18F]RO948 could distinguish patients with AD dementia from individuals without cognitive impairment and those with non-AD disorders, and the highest AUC was obtained using the I-IV ROI (AUC = 0.98; 95% CI, 0.96-0.99 for AD vs no cognitive impairment and AUC = 0.97; 95% CI, 0.95-0.99 for AD vs non-AD disorders), which outperformed MRI (highest AUC = 0.91 for AD vs no cognitive impairment using whole-brain thickness, and AUC = 0.80 for AD vs non-AD disorders using temporal lobe thickness) and cerebrospinal fluid measures (highest AUC = 0.94 for AD vs no cognitive impairment using Aβ42/p-tau181, and AUC = 0.93 for AD vs non-AD disorders using Aβ42/Aβ40). Generally, tau PET positivity using [18F]RO948 was observed only in Aβ-positive cases or in MAPT R406W mutation carriers. Retention of [18F]RO948 was not pronounced in patients with svPPA, and head-to-head comparison revealed lower temporal lobe uptake than with [18F]flortaucipir. Conclusions and Relevance In this study, elevated [18F]RO948 SUVRs were most often seen among Aβ-positive cases, which suggests that [18F]RO948 has high specificity for AD-type tau and highlights its potential as a diagnostic marker in the differential diagnosis of AD.
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Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | | | | | | | - Tomas Ohlsson
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Jonas Jögi
- Skåne University Hospital, Department of Clinical Physiology and Nuclear Medicine, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Boccardi M, Dodich A, Albanese E, Gayet-Ageron A, Festari C, Ashton NJ, Bischof GN, Chiotis K, Leuzy A, Wolters EE, Walter MA, Rabinovici GD, Carrillo M, Drzezga A, Hansson O, Nordberg A, Ossenkoppele R, Villemagne VL, Winblad B, Frisoni GB, Garibotto V. The strategic biomarker roadmap for the validation of Alzheimer's diagnostic biomarkers: methodological update. Eur J Nucl Med Mol Imaging 2021; 48:2070-2085. [PMID: 33688996 PMCID: PMC8175304 DOI: 10.1007/s00259-020-05120-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/15/2020] [Indexed: 12/11/2022]
Abstract
Background The 2017 Alzheimer’s disease (AD) Strategic Biomarker Roadmap (SBR) structured the validation of AD diagnostic biomarkers into 5 phases, systematically assessing analytical validity (Phases 1–2), clinical validity (Phases 3–4), and clinical utility (Phase 5) through primary and secondary Aims. This framework allows to map knowledge gaps and research priorities, accelerating the route towards clinical implementation. Within an initiative aimed to assess the development of biomarkers of tau pathology, we revised this methodology consistently with progress in AD research. Methods We critically appraised the adequacy of the 2017 Biomarker Roadmap within current diagnostic frameworks, discussed updates at a workshop convening the Alzheimer’s Association and 8 leading AD biomarker research groups, and detailed the methods to allow consistent assessment of aims achievement for tau and other AD diagnostic biomarkers. Results The 2020 update applies to all AD diagnostic biomarkers. In Phases 2–3, we admitted a greater variety of study designs (e.g., cross-sectional in addition to longitudinal) and reference standards (e.g., biomarker confirmation in addition to clinical progression) based on construct (in addition to criterion) validity. We structured a systematic data extraction to enable transparent and formal evidence assessment procedures. Finally, we have clarified issues that need to be addressed to generate data eligible to evidence-to-decision procedures. Discussion This revision allows for more versatile and precise assessment of existing evidence, keeps up with theoretical developments, and helps clinical researchers in producing evidence suitable for evidence-to-decision procedures. Compliance with this methodology is essential to implement AD biomarkers efficiently in clinical research and diagnostics.
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Affiliation(s)
- Marina Boccardi
- German Center for Neurodegenerative Diseases DZNE-Standort Rostock/Greifswald, Gehlsheimer Str. 20, 18147, Rostock, Germany.
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland.
| | - Alessandra Dodich
- Center for Neurocognitive Rehabilitation (CeRiN), CIMeC, University of Trento, Trento, Italy
- NIMTlab - Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
| | - Emiliano Albanese
- USI - Università della Svizzera Italiana, Institute of Public Health (IPH), Lugano, Switzerland
| | - Angèle Gayet-Ageron
- Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Cristina Festari
- LANE - Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at The University of Gothenburg, Molndal, Sweden
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gérard N Bischof
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Konstantinos Chiotis
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Antoine Leuzy
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Emma E Wolters
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Martin A Walter
- Nuclear Medicine and Molecular Division, Geneva Medical Hospital, Geneva, Switzerland
| | - Gil D Rabinovici
- Departments of Neurology, Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA
| | | | - Alexander Drzezga
- Faculty of Medicine, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany
- Molecular Organization of the Brain, Research Center Jülich, Institute of Neuroscience and Medicine (INM-2), Julich, Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmo, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Theme Aging, Geriatric Clinic, Huddinge, Sweden
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Department of Clinical Memory Research, Lund University, Lund, Sweden
| | - Victor L Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, Melbourne, VIC, Australia
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsilvania, USA
| | - Bengt Winblad
- Karolinska University Hospital, Theme Aging, Geriatric Clinic, Huddinge, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni B Frisoni
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
- Memory Clinic, University Hospital, Geneva, Switzerland
| | - Valentina Garibotto
- NIMTlab - Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
- Nuclear Medicine and Molecular Division, Geneva Medical Hospital, Geneva, Switzerland
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Benedet AL, Leuzy A, Pascoal TA, Ashton NJ, Mathotaarachchi S, Savard M, Therriault J, Kang MS, Chamoun M, Schöll M, Zimmer ER, Gauthier S, Labbe A, Zetterberg H, Rosa-Neto P, Blennow K. Stage-specific links between plasma neurofilament light and imaging biomarkers of Alzheimer's disease. Brain 2021; 143:3793-3804. [PMID: 33210117 DOI: 10.1093/brain/awaa342] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/28/2020] [Accepted: 08/17/2020] [Indexed: 11/12/2022] Open
Abstract
Neurofilament light (NfL) is a marker of neuroaxonal injury, a prominent feature of Alzheimer's disease. It remains uncertain, however, how it relates to amyloid and tau pathology or neurodegeneration across the Alzheimer's disease continuum. The aim of this study was to investigate how plasma NfL relates to amyloid and tau PET and MRI measures of brain atrophy in participants with and without cognitive impairment. We retrospectively examined the association between plasma NfL and MRI measures of grey/white matter volumes in the Alzheimer's Disease Neuroimaging Initiative [ADNI: n = 1149; 382 cognitively unimpaired control subjects and 767 cognitively impaired participants (mild cognitive impairment n = 420, Alzheimer's disease dementia n = 347)]. Longitudinal plasma NfL was measured using single molecule array (Simoa) technology. Cross-sectional associations between plasma NfL and PET amyloid and tau measures were independently assessed in two cohorts: ADNI [n = 198; 110 cognitively unimpaired, 88 cognitively impaired (MCI n = 67, Alzheimer's disease dementia n = 21), data accessed October 2018]; and Translational Biomarkers in Aging and Dementia [TRIAD, n = 116; 74 cognitively unimpaired, 42 cognitively impaired (MCI n = 16, Alzheimer's disease dementia n = 26), data obtained November 2017 to January 2019]. Associations between plasma NfL and imaging-derived measures were examined voxel-wise using linear regression (cross-sectional) and linear mixed effect models (longitudinal). Cross-sectional analyses in both cohorts showed that plasma NfL was associated with PET findings in brain regions typically affected by Alzheimer's disease; associations were specific to amyloid PET in cognitively unimpaired and tau PET in cognitively impaired (P < 0.05). Longitudinal analyses showed that NfL levels were associated with grey/white matter volume loss; grey matter atrophy in cognitively unimpaired was specific to APOE ε4 carriers (P < 0.05). These findings suggest that plasma NfL increases in response to amyloid-related neuronal injury in preclinical stages of Alzheimer's disease, but is related to tau-mediated neurodegeneration in symptomatic patients. As such, plasma NfL may a useful measure to monitor effects in disease-modifying drug trials.
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Affiliation(s)
- Andréa L Benedet
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada.,CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Tharick A Pascoal
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK.,NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
| | - Sulantha Mathotaarachchi
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | - Melissa Savard
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | - Joseph Therriault
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | - Min Su Kang
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | - Mira Chamoun
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada
| | - Michael Schöll
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Eduardo R Zimmer
- Alzheimer's Disease Research Unit, The McGill University Research Centre for Studies in Aging, Montreal, McGill University, Montreal, QC, Canada.,Departament of Pharmacology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Serge Gauthier
- Alzheimer's Disease Research Unit, The McGill University Research Centre for Studies in Aging, Montreal, McGill University, Montreal, QC, Canada
| | - Aurélie Labbe
- Department of Decision Sciences, HEC Montreal, Montreal, QC, Canada
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,UK Dementia Research Institute at UCL, London, UK
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, McGill University, Montreal, QC, Canada.,Alzheimer's Disease Research Unit, The McGill University Research Centre for Studies in Aging, Montreal, McGill University, Montreal, QC, Canada.,Montreal Neurological Institute, Montreal, QC, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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Smith R, Strandberg O, Mattsson-Carlgren N, Leuzy A, Palmqvist S, Pontecorvo MJ, Devous MD, Ossenkoppele R, Hansson O. The accumulation rate of tau aggregates is higher in females and younger amyloid-positive subjects. Brain 2021; 143:3805-3815. [PMID: 33439987 PMCID: PMC7805812 DOI: 10.1093/brain/awaa327] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/21/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023] Open
Abstract
The development of tau-PET allows paired helical filament tau pathology to be visualized in vivo. Increased knowledge about conditions affecting the rate of tau accumulation could guide the development of therapies halting the progression of Alzheimer’s disease. However, the factors modifying the rate of tau accumulation over time in Alzheimer’s disease are still largely unknown. Large-scale longitudinal cohort studies, adjusting for baseline tau load, are needed to establish such risk factors. In the present longitudinal study, 419 participants from four cohorts in the USA (Avid 05e, n = 157; Expedition-3, n = 82; ADNI, n = 123) and Sweden (BioFINDER, n = 57) were scanned repeatedly with tau-PET. The study participants were cognitively unimpaired (n = 153), or patients with mild cognitive impairment (n = 139) or Alzheimer’s disease dementia (n = 127). Participants underwent two to four tau-PET (18F-flortaucipir) scans with a mean (± standard deviation) of 537 (±163) days between the first and last scan. The change in tau-PET signal was estimated in temporal meta- and neocortical regions of interest. Subject specific tau-PET slopes were predicted simultaneously by age, sex, amyloid status (determined by amyloid-β PET), APOE ε4 genotype, study cohort, diagnosis and baseline tau load. We found that accelerated increase in tau-PET signal was observed in amyloid-β-positive mild cognitive impairment (3.0 ± 5.3%) and Alzheimer’s disease dementia (2.9 ± 5.7%), respectively, when compared to either amyloid-β-negative cognitively unimpaired (0.4 ± 2.7%), amyloid-β-negative mild cognitive impairment (−0.4 ± 2.3%) or amyloid-β-positive cognitively unimpaired (1.2 ± 2.8%). Tau-PET uptake was accelerated in females (temporal region of interest: t = 2.86, P = 0.005; neocortical region of interest: t = 2.90, P = 0.004), younger individuals (temporal region of interest: t = −2.49, P = 0.013), and individuals with higher baseline tau-PET signal (temporal region of interest: t = 3.83, P < 0.001; neocortical region of interest: t = 5.01, P < 0.001). Tau-PET slopes decreased with age in amyloid-β-positive subjects, but were stable by age in amyloid-β-negative subjects (age × amyloid-β status interaction: t = −2.39, P = 0.018). There were no effects of study cohort or APOE ε4 positivity. In a similar analysis on longitudinal amyloid-β-PET (in ADNI subjects only, n = 639), we found significant associations between the rate of amyloid-β accumulation and APOE ε4 positivity, older age and baseline amyloid-β positivity, but no effect of sex. In conclusion, in this longitudinal PET study comprising four cohorts, we found that the tau accumulation rate is greater in females and younger amyloid-β-positive individuals, while amyloid-β accumulation is greater in APOE ε4 carriers and older individuals. These findings are important considerations for the design of clinical trials, and might improve our understanding of factors associated with faster tau aggregation and spread.
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Affiliation(s)
- Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden
| | | | | | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Amsterdam University Medical Center, Alzheimercenter, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden
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40
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Johansson M, Stomrud E, Insel PS, Leuzy A, Johansson PM, Smith R, Ismail Z, Janelidze S, Palmqvist S, van Westen D, Mattsson-Carlgren N, Hansson O. Mild behavioral impairment and its relation to tau pathology in preclinical Alzheimer's disease. Transl Psychiatry 2021; 11:76. [PMID: 33500386 PMCID: PMC7838407 DOI: 10.1038/s41398-021-01206-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/14/2020] [Accepted: 01/07/2021] [Indexed: 12/17/2022] Open
Abstract
Mild behavioral impairment (MBI) is suggested as risk marker for neurodegenerative diseases, such as Alzheimer's disease (AD). Recently, pathologic tau deposition in the brain has been shown closely related to clinical manifestations, such as cognitive deficits. Yet, associations between tau pathology and MBI have rarely been investigated. It is further debated if MBI precedes cognitive deficits in AD. Here, we explored potential mechanisms by which MBI is related to AD, this by studying associations between MBI and tau in preclinical AD. In all, 50 amyloid-β-positive cognitively unimpaired subjects (part of the BioFINDER-2 study) underwent MBI-checklist (MBI-C) to assess MBI, and the Alzheimer's Disease Assessment Scale - Cognitive subscale (ADAS-Cog) delayed word recall (ADAS-DR) to assess episodic memory. Early tau pathology was determined using tau-PET ([18F]RO948 retention in entorhinal cortex/hippocampus) and cerebrospinal fluid (CSF) P-tau181. Regression models were used to test for associations. We found that higher tau-PET signal in the entorhinal cortex/hippocampus and CSF P-tau181 levels were associated with higher MBI-C scores (β = 0.010, SE = 0.003, p = 0.003 and β = 1.263, SE = 0.446, p = 0.007, respectively). When MBI-C and ADAS-DR were entered together in the regression models, tau-PET (β = 0.009, p = 0.009) and CSF P-tau181 (β = 0.408, p = 0.006) were predicted by MBI-C, but not ADAS-DR. We conclude that in preclinical AD, MBI is associated with tau independently from memory deficits. This denotes MBI as an important early clinical manifestation related to tau pathology in AD.
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Affiliation(s)
- Maurits Johansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SUS, Malmö, Sweden. .,Division of Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Lund University, Helsingborg, Sweden. .,Department of Psychiatry, Helsingborg Hospital, Helsingborg, Sweden.
| | - Erik Stomrud
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SUS, Malmö, Sweden ,grid.411843.b0000 0004 0623 9987Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Philip S. Insel
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SUS, Malmö, Sweden ,grid.266102.10000 0001 2297 6811Department of Psychiatry, University of California, San Francisco, CA USA
| | - Antoine Leuzy
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SUS, Malmö, Sweden
| | - Per Mårten Johansson
- grid.4514.40000 0001 0930 2361Division of Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Lund University, Helsingborg, Sweden ,grid.8761.80000 0000 9919 9582Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ruben Smith
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SUS, Malmö, Sweden ,grid.411843.b0000 0004 0623 9987Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Zahinoor Ismail
- grid.22072.350000 0004 1936 7697Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Hotchkiss Brain Institute and O’Brien Institute for Public Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB Canada
| | - Shorena Janelidze
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SUS, Malmö, Sweden
| | - Sebastian Palmqvist
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SUS, Malmö, Sweden ,grid.411843.b0000 0004 0623 9987Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Danielle van Westen
- grid.4514.40000 0001 0930 2361Diagnostic Radiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden ,grid.411843.b0000 0004 0623 9987Image and Function, Skåne University Hospital, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- grid.4514.40000 0001 0930 2361Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SUS, Malmö, Sweden ,grid.411843.b0000 0004 0623 9987Department of Neurology, Skåne University Hospital, Lund, Sweden ,grid.4514.40000 0001 0930 2361Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SUS, Malmö, Sweden. .,Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Hall S, Janelidze S, Londos E, Leuzy A, Stomrud E, Dage JL, Hansson O. Plasma Phospho-Tau Identifies Alzheimer's Co-Pathology in Patients with Lewy Body Disease. Mov Disord 2020; 36:767-771. [PMID: 33285015 PMCID: PMC8048822 DOI: 10.1002/mds.28370] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/22/2020] [Accepted: 10/05/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Alzheimer's disease co-pathology is common in dementia with Lewy bodies and Parkinson's disease with dementia (Lewy body disease) and can reliably be detected with positron emission tomography (PET) or cerebrospinal fluid (CSF) biomarkers. Recently developed blood biomarkers are more accessible and less expensive alternatives. OBJECTIVE To investigate if plasma phospho-tau217 and phospho-tau181 can detect Alzheimer's pathology in Lewy body disease with dementia. METHODS In this cross-sectional study we investigated plasma phospho-tau217 and phospho-tau181 in 35 patients with Lewy body disease with dementia. Patients underwent tau-PET imaging (18 F-RO948). RESULTS Plasma phospho-tau217 correlated with plasma phospho-tau181, CSF phospho-tau217 (rs = 0.68, P < 0.001), and negatively with CSF β-amyloid42/40 (rs = -0.52, P = 0.001). Plasma phospho-tau217 and phospho-tau181 correlated with tau-PET signal in the temporal cortex (rs > 0.56, P < 0.001) and predicted abnormal tau-PET status and β-amyloid status (area under the curve > 0.78 and > 0.81, respectively). CONCLUSION Plasma phospho-tau might be a useful marker for Alzheimer's co-pathology in Lewy body disease with dementia. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sara Hall
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Elisabet Londos
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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42
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Wolters EE, Chiotis K, Dodich A, Ashton NJ, Barthel H, Bischof GN, Boccardi M, Carrillo MC, Corre J, Démonet J, Drzezga A, Gietl AF, Hansson O, Johnson KA, Leuzy A, Lorenzi M, Rabinovici GD, Ratib O, Sabri O, Treyer V, Unschuld PG, Villemagne VL, Winblad B, Frisoni GB, Garibotto V, Nordberg AK, Ossenkoppele R. Alzheimer’s disease biomarker roadmap 2020: [
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F]flortaucipir. Alzheimers Dement 2020. [DOI: 10.1002/alz.039550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Emma E. Wolters
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | | | - Nicholas J. Ashton
- Wallenberg Centre for Molecular and Translational Medicine University of Gothenburg Gothenburg Sweden
| | - Henryk Barthel
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | | | | | | | - Julie Corre
- Centre National de la Recherche Scientifique Montpellier France
| | - Jean‐François Démonet
- Department of Clinical Neurosciences Leenaards Memory Centre Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland
| | | | - Anton F. Gietl
- Institute for Regenerative Medicine University of Zurich Schlieren Switzerland
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Keith A. Johnson
- Gordon Center for Medical Imaging Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | - Gil D. Rabinovici
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Osman Ratib
- Geneva University Hospitals Geneva Switzerland
| | - Osama Sabri
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Valerie Treyer
- Institute for Regenerative Medicine University of Zurich Schlieren Switzerland
| | - Paul G. Unschuld
- Hospital for Psychogeriatric Medicine University of Zurich Zurich Switzerland
| | | | | | | | - Valentina Garibotto
- Division of Nuclear Medicine Geneva University Hospitals and University of Geneva Geneva Switzerland
| | | | - Rik Ossenkoppele
- VU University Medical Center Amsterdam UMC Amsterdam Netherlands
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43
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Bischof GN, Dodich A, Ashton NJ, Boccardi M, Barthel H, Carrillo MC, Chiotis K, Corre J, Démonet J, Gietl AF, Johnson KA, Hansson O, Leuzy A, Lorenzi M, Nordberg AK, Ossenkoppele R, Rabinovici GD, Ratib O, Sabri O, Treyer V, Unschuld PG, Villemagne VL, Wolters EE, Winblad B, Frisoni GB, Garibotto V, Drzezga A. Alzheimer’s disease biomarker roadmap 2020: Second‐generation tau PET tracers. Alzheimers Dement 2020. [DOI: 10.1002/alz.039556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine University of Gothenburg Gothenburg Sweden
| | | | - Henryk Barthel
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | | | | | - Julie Corre
- Centre National de la Recherche Scientifique Montpellier France
| | - Jean‐François Démonet
- Department of Clinical Neurosciences Leenaards Memory Centre Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland
| | - Anton F. Gietl
- Institute for Regenerative Medicine University of Zurich Schlieren Switzerland
| | - Keith A. Johnson
- Gordon Center for Medical Imaging Massachusetts General Hospital Harvard Medical School Boston MA USA
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | | | - Rik Ossenkoppele
- VU University Medical Center Amsterdam UMC Amsterdam Netherlands
| | - Gil D. Rabinovici
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Osman Ratib
- Geneva University Hospitals Geneva Switzerland
| | - Osama Sabri
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Valerie Treyer
- Institute for Regenerative Medicine University of Zurich Schlieren Switzerland
| | - Paul G. Unschuld
- Hospital for Psychogeriatric Medicine University of Zurich Zurich Switzerland
| | | | - Emma E. Wolters
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | | | - Valentina Garibotto
- Division of Nuclear Medicine Geneva University Hospitals and University of Geneva Geneva Switzerland
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44
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Singleton EH, Hansson O, Dijkstra AA, Joie R, Mantyh WG, Tideman P, Stomrud E, Leuzy A, Johansson M, Strandberg O, Smith R, van Swieten JC, Papma JM, Wolters EE, Coomans EM, Golla SS, Tuncel H, Berendrecht E, Blujdea RE, Van Berckel BN, Bouwman F, Scheltens P, Pijnenburg YA, Rabinovici GD, Ossenkoppele R. Heterogeneous distribution of pathology in behavioral variant Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.044830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ellen H. Singleton
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Malmö Sweden
| | - Anke A. Dijkstra
- Department of Pathology Amsterdam Neuroscience Amsterdam University Medical Center Amsterdam Netherlands
| | - Renaud Joie
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - William G. Mantyh
- Department of Neurology Memory and Aging Center University of California San Francisco San Francisco CA USA
| | - Pontus Tideman
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Lund Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit Department of Clinical Sciences Malmö Lund University Malmö Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Maurits Johansson
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Lund Sweden
- Division of Clinical Sciences Department of Clinical Sciences Lund Lund University, Helsingborg Helsingborg Sweden
| | | | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - John C. van Swieten
- Alzheimer Center and Department of Neurology Erasmus University Medical Center Rotterdam Netherlands
- Erasmus MC Amsterdam Netherlands
| | - Janne M. Papma
- Erasmus Medical Centre Rotterdam Netherlands
- Department of Radiology Erasmus University Medical Center Rotterdam Netherlands
| | - Emma E. Wolters
- Department of Radiology & Nuclear Medicine Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Emma M. Coomans
- Department of Radiology & Nuclear Medicine Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Sandeep S.V. Golla
- Department of Radiology & Nuclear Medicine Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Hayel Tuncel
- Department of Radiology & Nuclear Medicine Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Evi Berendrecht
- Amsterdam Neuroscience Amsterdam University Medical Center Amsterdam Netherlands
| | - Raluca E. Blujdea
- Department of Pathology Amsterdam Neuroscience Amsterdam University Medical Center Amsterdam Netherlands
| | - Bart N.M. Van Berckel
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
| | - Femke Bouwman
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Netherlands
| | - Yolande A.L. Pijnenburg
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
| | - Gil D. Rabinovici
- Department of Neurology Memory and Aging Center University of California San Francisco San Francisco CA USA
- Department of Radiology and Biomedical Imaging University of California San Francisco San Francisco CA USA
- Molecular Biophysics and Integrated Bioimaging Division Lawrence Berkeley National Laboratory Berkeley CA USA
- Helen Wills Neuroscience Institute University of California Berkeley Berkeley CA USA
| | - Rik Ossenkoppele
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Lund Sweden
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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45
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Dodich A, Boccardi M, Ashton NJ, Barthel H, Bischof GN, Carrillo MC, Chiotis K, Corre J, Démonet J, Drzezga A, Gietl AF, Hansson O, Johnson KA, Leuzy A, Lorenzi M, Nordberg AK, Ossenkoppele R, Rabinovici GD, Ratib O, Sabri O, Treyer V, Unschuld PG, Villemagne VL, Winblad B, Wolters EE, Frisoni GB, Garibotto V. Alzheimer’s disease biomarker roadmap 2020: Time for tau. Alzheimers Dement 2020. [DOI: 10.1002/alz.039549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine University of Gothenburg Gothenburg Sweden
| | - Henryk Barthel
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | | | | | | | - Julie Corre
- Centre National de la Recherche Scientifique Montpellier France
| | - Jean‐François Démonet
- Department of Clinical Neurosciences Leenaards Memory Centre Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland
| | | | - Anton F. Gietl
- Institute for Regenerative Medicine University of Zurich Schlieren Switzerland
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Keith A. Johnson
- Gordon Center for Medical Imaging Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | | | - Rik Ossenkoppele
- VU University Medical Center, Amsterdam UMC Amsterdam Netherlands
| | - Gil D. Rabinovici
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Osman Ratib
- Geneva University Hospitals Geneva Switzerland
| | - Osama Sabri
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Valerie Treyer
- Institute for Regenerative Medicine University of Zurich Schlieren Switzerland
| | - Paul G. Unschuld
- Hospital for Psychogeriatric Medicine University of Zurich Zurich Switzerland
| | | | | | - Emma E. Wolters
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Giovanni B. Frisoni
- Memory Clinic and LANVIE‐Laboratory of Neuroimaging of Aging University Hospitals and University of Geneva Geneva Switzerland
| | - Valentina Garibotto
- Geneva University Hospitals Geneva Switzerland
- Division of Nuclear Medicine Geneva University Hospitals and University of Geneva Geneva Switzerland
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46
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Janelidze S, Palmqvist S, Quiroz YT, Lopera F, Stomrud E, Su Y, Chen Y, Serrano GE, Leuzy A, Mattsson N, Strandberg O, Smith R, Villegas A, Sepulveda D, Chai X, Proctor N, Zetterberg H, Beach TG, Blennow K, Reiman EM, Dage JL, Hansson O. Phospho‐tau217 and phospho‐tau181 in plasma and CSF as biomarkers for Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.037520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Erik Stomrud
- Memory Clinic Skåne University Hospital Malmö Sweden
| | - Yi Su
- Banner Alzheimer's Institute Phoenix AZ USA
| | | | | | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | - Olof Strandberg
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Lund Sweden
| | - Ruben Smith
- Neurology Clinic Skåne University Hospital Lund Sweden
| | - Andres Villegas
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Diego Sepulveda
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Xiyun Chai
- Eli Lilly and Company Indianapolis IN USA
| | | | - Henrik Zetterberg
- Institute of Neuroscience and Physiology the Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | | | - Kaj Blennow
- Sahlgrenska University Hospital Mölndal Sweden
| | | | | | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
- Clinical Memory Research Unit Department of Clinical Sciences Lund University Malmö Sweden
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47
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Pawlik D, Leuzy A, Strandberg O, Smith R. Compensating for choroid plexus based off‐target signal in the hippocampus using [
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F]flortaucipir PET. Alzheimers Dement 2020. [DOI: 10.1002/alz.041800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Daria Pawlik
- Clinical Memory Research Unit Lund University Malmö Sweden
- Skåne University Hospital Lund Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Mälmo Lund University Lund Sweden
| | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
- Neurology Clinic Skåne University Hospital Lund Sweden
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48
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Leuzy A, Lilja J, Ossenkoppele R, Palmqvist S, Janelidze S, Stomrud E, Strandberg O, Smith R, Hansson O. Derivation of a tau‐PET based pathology accumulation index to estimate global tau‐load. Alzheimers Dement 2020. [DOI: 10.1002/alz.045966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Johan Lilja
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | | | | | - Erik Stomrud
- Clinical Memory Research Unit Department of Clinical Sciences Malmö Lund University Malmö Sweden
| | | | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit Department of Clinical Sciences Malmö Lund University Malmö Sweden
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49
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Ashton NJ, Leuzy A, Karikari TK, Dodich A, Boccardi M, Barthel H, Bischof GN, Carrillo MC, Chiotis K, Corre J, Démonet J, Drzezga A, Gietl AF, Johnson KC, Lorenzi M, Nordberg AK, Ossenkoppele R, Rabinovici GD, Ratib O, Sabri O, Treyer V, Unschuld PG, Villemagne VLL, Winblad B, Wolters EE, Frisoni GB, Garibotto V, Mattsson N, Zetterberg H, Blennow K, Hansson O. Alzheimer’s disease biomarker roadmap 2020: Fluid biomarkers. Alzheimers Dement 2020. [DOI: 10.1002/alz.039557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine University of Gothenburg Gothenburg Sweden
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation London United Kingdom
- Institute of Psychiatry Psychology & Neuroscience King's College London London United Kingdom
- Department of Psychiatry and Neurochemistry Institute of Neuroscience & Physiology the Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | | | | | - Henryk Barthel
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Gerard N Bischof
- Medical Faculty and University Hospital of Cologne Cologne Germany
| | | | | | - Julie Corre
- Centre National de la Recherche Scientifique Montpellier France
| | - Jean‐François Démonet
- Department of Clinical Neurosciences Leenaards Memory Centre Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland
| | | | - Anton F. Gietl
- Institute for Regenerative Medicine University of Zurich Schlieren Switzerland
| | - Karen C Johnson
- University of Tennessee Health Science Center Memphis TN USA
| | | | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Gil D Rabinovici
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Osman Ratib
- Geneva University Hospitals Geneva Switzerland
| | - Osama Sabri
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Valerie Treyer
- Institute for Regenerative Medicine University of Zurich Schlieren Switzerland
| | - Paul G. Unschuld
- Hospital for Psychogeriatric Medicine University of Zurich Zurich Switzerland
| | | | | | - Emma E Wolters
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Giovanni B Frisoni
- Memory Clinic and LANVIE‐Laboratory of Neuroimaging of Aging University Hospitals and University of Geneva Geneva Switzerland
| | - Valentina Garibotto
- Division of Nuclear Medicine Geneva University Hospitals and University of Geneva Geneva Switzerland
| | | | | | | | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
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50
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Smith R, Strandberg O, Mattsson N, Leuzy A, Palmqvist S, Pontecorvo MJ, Devous MD, Ossenkoppele R, Hansson O. The accumulation rate of tau aggregates is higher in females and younger individuals. Alzheimers Dement 2020. [DOI: 10.1002/alz.043876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
- Neurology Clinic Skåne University Hospital Lund Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Lund Sweden
| | | | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | | | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Malmö Sweden
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