en
Scientific article
Open access
English

Plasma biomarkers for Alzheimer's disease: a field-test in a memory clinic

Published inJournal of neurology, neurosurgery and psychiatry, vol. 94, no. 6, p. 420-427
Publication date2023-06
First online date2023-04-03
Abstract

Background: The key Alzheimer's disease (AD) biomarkers are traditionally measured with techniques/exams that are either expensive (amyloid-positron emission tomography (PET) and tau-PET), invasive (cerebrospinal fluid Aβ42 and p-tau181), or poorly specific (atrophy on MRI and hypometabolism on fluorodeoxyglucose-PET). Recently developed plasma biomarkers could significantly enhance the efficiency of the diagnostic pathway in memory clinics and improve patient care. This study aimed to: (1) confirm the correlations between plasma and traditional AD biomarkers, (2) assess the diagnostic accuracy of plasma biomarkers as compared with traditional biomarkers, and (3) estimate the proportion of traditional exams potentially saved thanks to the use of plasma biomarkers.

Methods: Participants were 200 patients with plasma biomarkers and at least one traditional biomarker collected within 12 months.

Results: Overall, plasma biomarkers significantly correlated with biomarkers assessed through traditional techniques: up to r=0.50 (p<0.001) among amyloid, r=0.43 (p=0.002) among tau, and r=-0.23 (p=0.001) among neurodegeneration biomarkers. Moreover, plasma biomarkers showed high accuracy in discriminating the biomarker status (normal or abnormal) determined by using traditional biomarkers: up to area under the curve (AUC)=0.87 for amyloid, AUC=0.82 for tau, and AUC=0.63 for neurodegeneration status. The use of plasma as a gateway to traditional biomarkers using cohort-specific thresholds (with 95% sensitivity and 95% specificity) could save up to 49% of amyloid, 38% of tau, and 16% of neurodegeneration biomarkers.

Conclusion: The implementation of plasma biomarkers could save a remarkable proportion of more expensive traditional exams, making the diagnostic workup more cost-effective and improving patient care.

eng
Keywords
  • CSF
  • PET
  • Alzheimer's disease
  • Dementia
  • Memory
  • Humans
  • Alzheimer Disease / diagnostic imaging
  • Tau Proteins / cerebrospinal fluid
  • Amyloid beta-Peptides / cerebrospinal fluid
  • Biomarkers / cerebrospinal fluid
  • Positron-Emission Tomography
  • Peptide Fragments / cerebrospinal fluid
  • Cognitive Dysfunction / diagnosis
Funding
Citation (ISO format)
ALTOMARE, Daniele et al. Plasma biomarkers for Alzheimer’s disease: a field-test in a memory clinic. In: Journal of neurology, neurosurgery and psychiatry, 2023, vol. 94, n° 6, p. 420–427. doi: 10.1136/jnnp-2022-330619
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Identifiers
ISSN of the journal0022-3050
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Technical informations

Creation06/21/2023 6:18:18 AM
First validation07/04/2023 6:46:46 AM
Update time07/04/2023 6:46:46 AM
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