@article {Planchee473作者={文森特Planche文森特Bouteloup和伊莎贝尔Pellegrin让曼京和布鲁诺Dubois Pierre-Jean Ousset和佛罗伦萨Pasquier弗雷德里克·布兰科和克莱尔Paquet Olivier Hanon卡里姆本尼和马蒂厄Ceccaldi C {\ ' e} dric Annweiler和皮埃尔Krolak-Salmon Olivier Godefroy和大卫Wallon马蒂尔德Sauvee和克莱尔Boutoleau-Bretonni {\ ' e}再保险和伊莎贝尔Bourdel-Marchasson Isabelle Jalenques和吉纳维芙Chene卡罗尔Dufouil和纪念品研究小组},title ={血液生物标志物的有效性和性能预测阿尔茨海默病痴呆风险在一个大的诊断群组},体积={100}={5},页面= {e473——e484} = {2023}, doi = {10.1212 / WNL。出版商0000000000201479}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目的血液生物标志物对阿尔茨海默病(AD)一直被证明是与CSF或宠物相关生首页物标志物和有效区分广告与其他神经退行性疾病。我们的目的是测试他们的效用在临床实践中,从一个多中心没有前瞻性群组,患者遇到一个大范围的认知缺陷或投诉。方法纪念品队列招募了2323名门诊病人主观认知投诉(SCC)或轻度认知障碍(MCI)咨询在26日法国记忆诊所。参与者神经心理评估、核磁共振和血液采样在基线。CSF采样和淀粉样宠物是可选的。基线血液Aβ42/40比率、总τ,p181-tau,神经丝轻链(NfL)测量使用Simoa HD-X分析仪。一个专家委员会验证事件痴呆病例5年随访期间。结果总的来说,2277人至少有1基线可用血液生物标志物(n = 357 CSF子样品,宠物子样品n = 649),其中257人被诊断出患有痴呆临床AD /混合在随访中。所有血液生物标志物但总τ是温和与等价的CSF (r = 0.33 ~ 0.46, p \ < 0.0001),与淀粉pet状态有关(p < 0.0001)。血p181-tau是最好的血液生物标志物识别淀粉pet积极性(曲线下的面积= 0.74 (95 \ % CI = 0.69;0.79])。 Higher blood and CSF p181-tau and NfL concentrations were associated with accelerated time to AD dementia onset with similar incidence rates, whereas blood Aβ42/40 was less efficient than CSF Aβ42/40. Blood p181-tau alone was the best blood predictor of 5-year AD/mixed dementia risk (c-index = 0.73 [95\% CI = 0.69; 0.77]); its accuracy was higher in patients with clinical dementia rating (CDR) = 0 (c-index = 0.83 [95\% CI = 0.69; 0.97]) than in patients with CDR = 0.5 (c-index = 0.70 [95\% CI = 0.66; 0.74]). A {\textquotedblleft}clinical{\textquotedblright} reference model (combining demographics and neuropsychological assessment) predicted AD/mixed dementia risk with a c-index = 0.88 [95\% CI = 0.86{\textendash}0.91] and performance increased to 0.90 [95\% CI = 0.88; 0.92] when adding blood p181-tau + Aβ42/40. A {\textquotedblleft}research{\textquotedblright} reference model (clinical model + apolipoprotein E genotype and AD signature on MRI) had a c-index = 0.91 [95\% CI = 0.89{\textendash}0.93] increasing to 0.92 [95\% CI = 0.90; 0.93] when adding blood p181-tau + Aβ42/40. Chronic kidney disease and vascular comorbidities did not affect predictive performances.Discussion In a clinic-based cohort of patients with SCC or MCI, blood biomarkers may be good hallmarks of underlying pathology but add little to 5-year dementia risk prediction models including traditional predictors.Aβ=β-amyloid peptide; AD=Alzheimer disease; AUC=area under the curve; ApoE=apolipoprotein E; CDR=Clinical Dementia Rating; eGFR=estimated glomerular filtration rate; MCI=mild cognitive impairment; NfL=neurofilament light chain; ROC=receiver operating characteristic; SCC=subjective cognitive complaint; SUVR=standard uptake value ratio; TMT=Trail Making Test}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/100/5/e473}, eprint = {//www.ez-admanager.com/content/100/5/e473.full.pdf}, journal = {Neurology} }