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Mattias Ohlsson

Mattias Ohlsson

Professor

Mattias Ohlsson

Detailed comparison of amyloid PET and CSF biomarkers for identifying early Alzheimer disease

Author

  • Sebastian Palmqvist
  • H. Zetterberg
  • N. Mattsson
  • Per Johansson
  • Lennart Minthon
  • K. Blennow
  • Mattias Ohlsson
  • Oskar Hansson
  • Jimmy Lätt

Summary, in English

Objective:To compare the diagnostic accuracy of CSF biomarkers and amyloid PET for diagnosing early-stage Alzheimer disease (AD).Methods:From the prospective, longitudinal BioFINDER study, we included 122 healthy elderly and 34 patients with mild cognitive impairment who developed AD dementia within 3 years (MCI-AD). -Amyloid (A) deposition in 9 brain regions was examined with [F-18]-flutemetamol PET. CSF was analyzed with INNOTEST and EUROIMMUN ELISAs. The results were replicated in 146 controls and 64 patients with MCI-AD from the Alzheimer's Disease Neuroimaging Initiative study.Results:The best CSF measures for identifying MCI-AD were A42/total tau (t-tau) and A42/hyperphosphorylated tau (p-tau) (area under the curve [AUC] 0.93-0.94). The best PET measures performed similarly (AUC 0.92-0.93; anterior cingulate, posterior cingulate/precuneus, and global neocortical uptake). CSF A42/t-tau and A42/p-tau performed better than CSF A42 and A42/40 (AUC difference 0.03-0.12, p < 0.05). Using nonoptimized cutoffs, CSF A42/t-tau had the highest accuracy of all CSF/PET biomarkers (sensitivity 97%, specificity 83%). The combination of CSF and PET was not better than using either biomarker separately.Conclusions:Amyloid PET and CSF biomarkers can identify early AD with high accuracy. There were no differences between the best CSF and PET measures and no improvement when combining them. Regional PET measures were not better than assessing the global A deposition. The results were replicated in an independent cohort using another CSF assay and PET tracer. The choice between CSF and amyloid PET biomarkers for identifying early AD can be based on availability, costs, and doctor/patient preferences since both have equally high diagnostic accuracy.Classification of evidence:This study provides Class III evidence that amyloid PET and CSF biomarkers identify early-stage AD equally accurately.

Department/s

  • Clinical Memory Research
  • Computational Biology and Biological Physics
  • Artificial Intelligence in CardioThoracic Sciences (AICTS)
  • Medical Radiation Physics, Lund
  • MR Physics
  • MultiPark: Multidisciplinary research focused on Parkinson´s disease

Publishing year

2015

Language

English

Pages

1240-1249

Publication/Series

Neurology

Volume

85

Issue

14

Document type

Journal article

Publisher

American Academy of Neurology

Topic

  • Neurosciences

Keywords

  • MILD COGNITIVE IMPAIRMENT
  • POSITRON-EMISSION-TOMOGRAPHY
  • CEREBROSPINAL-FLUID
  • ASSOCIATION WORKGROUPS
  • DIAGNOSTIC GUIDELINES
  • NATIONAL INSTITUTE
  • BETA
  • TAU
  • DEMENTIA
  • RECOMMENDATIONS

Status

Published

Research group

  • Clinical Memory Research
  • Artificial Intelligence in CardioThoracic Sciences (AICTS)
  • MR Physics

ISBN/ISSN/Other

  • ISSN: 1526-632X