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  • Palmqvist, SebastianLund University,Lunds universitet,Klinisk minnesforskning,Forskargrupper vid Lunds universitet,Clinical Memory Research,Lund University Research Groups,Lund University, Lund, Sweden; Skåne University Hospital, Lund, Sweden (author)

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

  • Article/chapterEnglish2015

Publisher, publication year, extent ...

  • Lippincott Williams & Wilkins,2015
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:1a8076e5-53d3-48d4-a2eb-b67d898c9226
  • https://lup.lub.lu.se/record/8221211URI
  • https://doi.org/10.1212/WNL.0000000000001991DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-162694URI
  • https://gup.ub.gu.se/publication/224882URI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • 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.

Subject headings and genre

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  • Zetterberg, Henrik,1973Gothenburg University,Göteborgs universitet,University of Gothenburg,the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; the UCL Institute of Neurology, London, UK,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology(Swepub:gu)xzethe (author)
  • Mattsson, Niklas,1979Gothenburg University,Göteborgs universitet,University of Gothenburg,the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; University of California, San Francisco, USA; Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology(Swepub:gu)xmattn (author)
  • Johansson, PerGothenburg University,Göteborgs universitet,University of Gothenburg,Sahlgrenska Academy, University of Gothenburg, Sweden,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition(Swepub:gu)xjperq (author)
  • Minthon, LennartLund University,Lunds universitet,Klinisk minnesforskning,Forskargrupper vid Lunds universitet,Clinical Memory Research,Lund University Research Groups,Lund University, Lund, Sweden; Skåne University Hospital, Lund, Sweden(Swepub:lu)psyk-lmi (author)
  • Blennow, Kaj,1958Gothenburg University,Göteborgs universitet,University of Gothenburg,the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology(Swepub:gu)xbleka (author)
  • Ohlsson, MattiasLund University,Lunds universitet,Beräkningsbiologi och biologisk fysik - Genomgår omorganisation,Institutionen för astronomi och teoretisk fysik - Genomgår omorganisation,Naturvetenskapliga fakulteten,Artificiell intelligens och thoraxkirurgisk vetenskap (AICTS),Forskargrupper vid Lunds universitet,Computational Biology and Biological Physics - Undergoing reorganization,Department of Astronomy and Theoretical Physics - Undergoing reorganization,Faculty of Science,Artificial Intelligence in CardioThoracic Sciences (AICTS),Lund University Research Groups,Lund University, Lund, Sweden(Swepub:lu)thep-moh (author)
  • Hansson, OskarLund University,Lunds universitet,Klinisk minnesforskning,Forskargrupper vid Lunds universitet,Clinical Memory Research,Lund University Research Groups,Lund University, Lund, Sweden; Skåne University Hospital, Lund, Sweden(Swepub:lu)mphy-ohn (author)
  • Lätt, JimmyLund University,Lunds universitet,Medicinsk strålningsfysik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,MR Physics,Forskargrupper vid Lunds universitet,Medical Radiation Physics, Lund,Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups(Swepub:lu)radf-jla (author)
  • Nägga, KatarinaEnheten för Klinisk Minnesforskning, Inst för Kliniska Vetenskaper Malmö, Lunds Universitet (contributor)
  • Klinisk minnesforskningForskargrupper vid Lunds universitet (creator_code:org_t)
  • Swedish BioFINDER study group

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  • In:Neurology: Lippincott Williams & Wilkins85:14, s. 1240-12491526-632X0028-3878

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Palmqvist, Sebas ...
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Mattsson, Niklas ...
Johansson, Per
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Neurology
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Linköping University
University of Gothenburg

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