RT期刊文章SR电子T1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摩根富林明神经病学神经学乔FD Lippincott Williams &威尔金斯SP e473 OP e484 10.1212 / WNL。首页100签证官0000000000201479是5 A1文森特Planche A1 Bouteloup A1伊莎贝尔Pellegrin A1让曼京A1布鲁诺Dubois A1 Pierre-Jean Ousset A1佛罗伦萨Pasquier A1弗雷德里克·布兰科A1克莱尔Paquet A1 Olivier Hanon A1卡里姆本尼A1马修Ceccaldi A1塞德里克Annweiler A1皮埃尔Krolak-Salmon A1 Olivier Godefroy A1大卫Wallon A1马蒂尔德Sauvee A1克莱尔Boutoleau-Bretonniere A1伊莎贝尔Bourdel-Marchasson A1伊莎贝尔Jalenques A1吉纳维芙Chene A1卡罗尔Dufouil A1和纪念品研究小组2023年UL //www.ez-admanager.com/content/100/5/e473.abstract AB背景和客观的血液生物标志物对阿尔茨海默病(AD)一直被证明是与CSF或宠物相关生物标志物和有效区分广告与其他神经退行性疾病。首页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(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 “clinical” reference model (combining demographics and neuropsychological assessment) predicted AD/mixed dementia risk with a c-index = 0.88 [95% CI = 0.86–0.91] and performance increased to 0.90 [95% CI = 0.88; 0.92] when adding blood p181-tau + Aβ42/40. A “research” reference model (clinical model + apolipoprotein E genotype and AD signature on MRI) had a c-index = 0.91 [95% CI = 0.89–0.93] 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

map