JAMA Neurol: Tau-PET can predict preclinical and prodromal prognosis of AD

The typical pathological feature of Alzheimer’s disease is the deposition of amyloid and the increased concentration of phosphorylated tau protein.
The action of phosphatase causes the hyperphosphorylation of tau protein, which then falls off from the microtubules and aggregates to form neurofibrillary tangles.
This process destroys the structure of neuronal microtubules, hinders axon rotation, impairs synaptic function, and is accompanied by brain atrophy, which ultimately leads to a decline in cognitive ability in many areas
.

The PET tracer has a good affinity with the Tau protein aggregates formed in the brain of AD patients, and the deposition mode and degree of tau protein observed through tau-PET are related to the areas affected by Aβ deposition, brain atrophy and low metabolism.
The degree of overlap is high, and is related to cognitive decline in multiple cognitive functions
.

Ossenkoppele R et al.
conducted a multicenter longitudinal study to examine the prognostic value of [18F]flortaucipir and [18F]RO948 tau PET in 1431 patients with AD dementia, mild cognitive impairment (MCI) or normal cognition; PET was compared with established MRI and Aβ-PET markers to predict future cognitive changes; and whether age, gender, and Apoe genotype changed over time were associated with baseline Tau-PET and cognitive changes
.

The research results were published in JAMA Neurol

Ossenkoppele R et al.

The study included 8 cohorts, a total of 1431 subjects, and the average follow-up time was 1.
9 (0.
8) years
.

Among them, 673 patients with Aβ+ cognitive function were not impaired, 443 patients with Aβ+MCI, and 315 patients with Aβ+ AD dementia

In all participants, as well as in Aβ+MCI, Aβ+CU, and Aβ-CU, Tau-PET can better predict the decline of MMSE compared with MRI
.

2: In Aβ+AD and Aβ-MCI, MRI can better predict the decline of MMSE

In all participants, as well as in Aβ+MCI, Aβ+CU, and Aβ-CU, Tau-PET can better predict the decline of MMSE compared with MRI

Tau-PET can better predict the longitudinal changes of MMSE

In all participants and in each subgroup, Tau-PET can better predict the decline of MMSE compared with Amyloid-PET .

Tau-PET can better predict the decline of MMSE
.

Tau-PET can better predict the decline of MMSE

Mediation analysis was used to explore whether the correlation between baseline Tau-PET and cognitive changes was mediated by baseline cortical thickness.

It was found that in the AD dementia group and Aβ+MCI group, cortical thickness mediated the relationship between Tau-PET and MMSE

In the AD dementia group and the Aβ+MCI group, cortical thickness mediated the relationship between Tau-PET and MMSE

 

A linear mixed model was used to explore whether age, gender, and APOE genotype affected the relationship between baseline Tau-PET and MMSE changes.
It was found that age changed the relationship between baseline Tau-PET and MMSE changes, which showed that the elderly had similar Tau-PET levels Down, show faster cognitive decline
.

Age changes the relationship between baseline Tau-PET and MMSE changes, which is manifested as a faster cognitive decline in older people with similar Tau-PET levels
.

Age changes the relationship between baseline Tau-PET and MMSE changes, which is manifested as a faster cognitive decline in older people with similar Tau-PET levels

Tau-PET may be an ideal biomarker for predicting changes in the cognitive trajectory of individuals in the preclinical and prodromal stages of AD
.
Tau-PET may be an ideal biomarker for predicting changes in the cognitive trajectory of individuals in the preclinical and prodromal stages of AD
.

Original source:

Ossenkoppele R, Smith R, Mattsson-Carlgren N, et al.
Accuracy of Tau Positron Emission Tomography as a Prognostic Marker in Preclinical and Prodromal Alzheimer Disease: A Head-to-Head Comparison Against Amyloid Positron Emission Tomography and Magnetic Resonance Imaging.
JAMA Neurol .
2021;78(8):961-971.
doi:10.
1001/jamaneurol.
2021.
1858

Ossenkoppele R, Smith R, Mattsson-Carlgren N, et al.
Accuracy of Tau Positron Emission Tomography as a Prognostic Marker in Preclinical and Prodromal Alzheimer Disease: A Head-to-Head Comparison Against Amyloid Positron Emission Tomography and Magnetic Resonance Imaging.
JAMA Neurol .
2021;78(8):961-971.
doi:10.
1001/jamaneurol.
2021.
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