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In vivo detection of brain pathophysiological processes in Alzheimer's disease (AD) is the key to accurate diagnosis and proper care
.
Cerebrospinal fluid (CSF) and positron tomography of amyloid and tau biomarkers can accurately detect AD, but their use in clinical practice is limited due to related costs, invasiveness, or lack of access to the required tools
diagnosis
Neurofilament light chain (NfL) protein and tau181 (p-tau181) phosphorylated at threonine 181 are promising blood biomarkers for AD
.
The blood level of NfL is considered to be a biomarker of axon damage and neuronal damage, and was found to increase in clinically diagnosed AD compared to healthy controls
In this way, Christopher Clark and others of the University of Zurich explored the ability of plasma NfL and plasma p-tau181 levels or their combination as blood biomarkers for diagnosing brain AD pathology and predicting clinical disease progression
.
They measured plasma NfL and p-tau181 and established AD pathological biomarkers in memory clinic patients with normal cognitive (CN) and cognitive impairment (mild cognitive impairment and dementia, CI)
.
Clinical and neuropsychological evaluations were performed at the time of enrollment and 18 and 36 months of follow-up
Compared with CN non-AD, CN participants with AD CSF characteristics (defined as CSF p-tau181/Aβ1-42> 0.
0779) had higher plasma NfL levels, while p-tau181 plasma levels were higher in AD patients with CI
In CN patients, plasma NfL levels are correlated with CSF tau and p-tau181, and in CI patients with CSF tau
.
Plasma p-tau181 is related to CSF p-tau181 of CN patients, and is related to CSF tau, p-tau181, Aβ1-42 and Aβ1-42/Aβ1-40 of CI patients
Compared with the reference model, the addition of plasma p-tau181 can improve the prediction rate of AD in CI patients, while the addition of NfL does not increase the prediction rate
.
Adding p-tau181 to the reference model instead of NfL levels can improve the prediction of cognitive decline in CI participants
.
The important significance of this study lies in the discovery: plasma NfL indicates neurodegeneration, and plasma p-tau181 level can be used as a biomarker of brain AD pathology and cognitive decline
.
Their predictive performance depends on the presence or absence of cognitive dysfunction
Plasma NfL indicates neurodegeneration, and plasma p-tau181 level can be used as a biomarker of brain AD pathology and cognitive decline
Original source:
Clark C, Lewczuk P, Kornhuber J, et al.
Plasma neurofilament light and phosphorylated tau 181 as biomarkers of Alzheimer's disease pathology and clinical disease progression.
Alz Res Therapy.
2021;13(1):65.
Plasma neurofilament light and phosphorylated tau 181 as biomarkers of Alzheimer's disease pathology and clinical disease progression.
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