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. 2020 Mar;26(3):379-386.
doi: 10.1038/s41591-020-0755-1. Epub 2020 Mar 2.

Plasma P-tau181 in Alzheimer's disease: relationship to other biomarkers, differential diagnosis, neuropathology and longitudinal progression to Alzheimer's dementia

Shorena Janelidze #  1 , Niklas Mattsson #  2   3   4 , Sebastian Palmqvist  2   3 , Ruben Smith  2   3 , Thomas G Beach  5 , Geidy E Serrano  5 , Xiyun Chai  6 , Nicholas K Proctor  6 , Udo Eichenlaub  7 , Henrik Zetterberg  8   9   10   11 , Kaj Blennow  8   9 , Eric M Reiman  12 , Erik Stomrud  2   13 , Jeffrey L Dage  6 , Oskar Hansson  14   15
Affiliations

Plasma P-tau181 in Alzheimer's disease: relationship to other biomarkers, differential diagnosis, neuropathology and longitudinal progression to Alzheimer's dementia

Shorena Janelidze et al. Nat Med. 2020 Mar.

Abstract

Plasma phosphorylated tau181 (P-tau181) might be increased in Alzheimer's disease (AD), but its usefulness for differential diagnosis and prognosis is unclear. We studied plasma P-tau181 in three cohorts, with a total of 589 individuals, including cognitively unimpaired participants and patients with mild cognitive impairment (MCI), AD dementia and non-AD neurodegenerative diseases. Plasma P-tau181 was increased in preclinical AD and further increased at the MCI and dementia stages. It correlated with CSF P-tau181 and predicted positive Tau positron emission tomography (PET) scans (area under the curve (AUC) = 0.87-0.91 for different brain regions). Plasma P-tau181 differentiated AD dementia from non-AD neurodegenerative diseases with an accuracy similar to that of Tau PET and CSF P-tau181 (AUC = 0.94-0.98), and detected AD neuropathology in an autopsy-confirmed cohort. High plasma P-tau181 was associated with subsequent development of AD dementia in cognitively unimpaired and MCI subjects. In conclusion, plasma P-tau181 is a noninvasive diagnostic and prognostic biomarker of AD, which may be useful in clinical practice and trials.

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References

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