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PLASMA PHOSPHO-TAU231 ACCURATELY IDENTIFIES MILD COGNITIVE IMPAIRMENT AND DEMENTIA DUE TO ALZHEIMER’S DISEASE IN A CLINICAL SETTING
Abstract
Aims
To study the diagnostic performance of plasma phospho-tau231 (p-tau231) to identify mild cognitive impairment (MCI) and dementia due to Alzheimer’s disease (AD) in a memory clinic setting and compare its utility with plasma neurofilament light chain (NfL).
Methods
We retrospectively enrolled consecutive patients investigated for a cognitive complaint at the Cognitive Neurology Centre, Hospital Lariboisière, France, including 30 neurological controls, 63 patients with MCI due to AD (AD-MCI), 103 with AD dementia, 72 with MCI due to other disorders (MCI-other) and 35 with non-AD dementia (other dementia). Plasma p-tau231 and plasma NfL were measured using the Simoa platform. We used receiver operating characteristic curves and DeLong test to study performance of plasma markers alone and in combination with clinical measures for diagnosis of AD.
Results
Plasma p-tau231 and plasma NfL were increased in AD patients from the MCI stage (both p<0.0001). Alone, plasma p-tau231 and plasma NfL discriminated patients with AD-MCI from controls with similar performance (respectively AUC=0.86 and AUC=0.80, pDeLong=0.283). A clinical model (age, sex and MMSE) yielded an AUC of 0.87 but did not differ from plasma p-tau231 or plasma NfL (respectively, pDeLong=0.283 and pDeLong=0.063). Plasma p-tau231 distinguished AD-MCI from MCI-other (AUC=0.78), as well as AD dementia from other dementia individuals (AUC=0.85) both better than plasma NfL (respectively, AUC=0.68 and AUC=0.73). Combining plasma p-tau231, plasma NfL and clinical variables did not significantly outperform plasma p-tau231 alone.
Conclusions
Plasma p-tau231 is effective for the diagnosis of AD at MCI stage in a memory clinic setting, and displays higher diagnostic performance than plasma NfL.