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. 2023 Mar;19(3):749-760.
doi: 10.1002/alz.12700. Epub 2022 Jun 6.

A combination model of AD biomarkers revealed by machine learning precisely predicts Alzheimer's dementia: China Aging and Neurodegenerative Initiative (CANDI) study

Feng Gao  1   2 , Xinyi Lv  1 , Linbin Dai  1   2 , Qiong Wang  1   2 , Peng Wang  3 , Zhaozhao Cheng  1 , Qiang Xie  4 , Ming Ni  4 , Yan Wu  1 , Xianliang Chai  1 , Wenjing Wang  1 , Huaiyu Li  1 , Feng Yu  1 , Yuqin Cao  1 , Fang Tang  1 , Bo Pan  4 , Guoping Wang  1 , Kexue Deng  3 , Shicun Wang  4 , Qiqiang Tang  1 , Jiong Shi  5 , Yong Shen  1   2
Affiliations

A combination model of AD biomarkers revealed by machine learning precisely predicts Alzheimer's dementia: China Aging and Neurodegenerative Initiative (CANDI) study

Feng Gao et al. Alzheimers Dement. 2023 Mar.

Abstract

Introduction: To test the utility of the "A/T/N" system in the Chinese population, we study core Alzheimer's disease (AD) biomarkers in a newly established Chinese cohort.

Methods: A total of 411 participants were selected, including 96 cognitively normal individuals, 94 patients with mild cognitive impairment (MCI) patients, 173 patients with AD, and 48 patients with non-AD dementia. Fluid biomarkers were measured with single molecule array. Amyloid beta (Aβ) deposition was determined by 18F-Flobetapir positron emission tomography (PET), and brain atrophy was quantified using magnetic resonance imaging (MRI).

Results: Aβ42/Aβ40 was decreased, whereas levels of phosphorylated tau (p-tau) were increased in cerebrospinal fluid (CSF) and plasma from patients with AD. CSF Aβ42/Aβ40, CSF p-tau, and plasma p-tau showed a high concordance in discriminating between AD and non-AD dementia or elderly controls. A combination of plasma p-tau, apolipoprotein E (APOE) genotype, and MRI measures accurately predicted amyloid PET status.

Discussion: These results revealed a universal applicability of the "A/T/N" framework in a Chinese population and established an optimal diagnostic model consisting of cost-effective and non-invasive approaches for diagnosing AD.

Keywords: Alzheimer's disease; MRI; amyloid PET; fluid biomarker.

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