Combining cerebrospinal fluid and PI‐2620 tau‐PET for biomarker‐based stratification of Alzheimer's disease and 4R‐tauopathies

Dilcher, Roxane ; Wall, Stephan; Gross, Mattes; Katzdobler, Sabrina ; Wagemann, Olivia; Palleis, Carla ; Weidinger, Endy; Fietzek, Urban M ; Bernhardt, Alexander M. ; Kurz, Carolin; Ferschmann, Christian; Scheifele, Maximilian; Zaganjori, Mirlind; Gnörich, Johannes ; Bürger, Katharina; Janowitz, Daniel; Rauchmann, Boris‐Stephan; Stöcklein, Sophia ; Bartenstein, Peter ; Villemagne, Victor L.; Seibyl, John; Sabri, Osama ; Barthel, Henryk; Perneczky, Robert ; Schöberl, Florian; Zwergal, Andreas ; Höglinger, Günter U. ; Levin, Johannes ; Franzmeier, Nicolai und Brendel, Matthias (2024): Combining cerebrospinal fluid and PI‐2620 tau‐PET for biomarker‐based stratification of Alzheimer's disease and 4R‐tauopathies. In: Alzheimer's & Dementia, Vol. 20, No. 10: pp. 6896-6909

Abstract

Introduction : Recent advances in biomarker research have improved the diagnosis and monitoring of Alzheimer's disease (AD), but in vivo biomarker‐based workflows to assess 4R‐tauopathy (4RT) patients are currently missing. We suggest a novel biomarker‐based algorithm to characterize AD and 4RTs. Methods : We cross‐sectionally assessed combinations of cerebrospinal fluid measures (CSF p‐tau181 and t‐tau) and ¹⁸F‐PI‐2620 tau‐positron emission tomography (PET) in patients with AD (n = 64), clinically suspected 4RTs (progressive supranuclear palsy or corticobasal syndrome, n = 82) and healthy controls (n = 19). Results : Elevated CSF p‐tau181 and cortical ¹⁸F‐PI‐2620 binding was characteristic for AD while normal CSF p‐tau181 with elevated subcortical ¹⁸F‐PI‐2620 binding was characteristic for 4RTs. ¹⁸F‐PI‐2620‐assessed posterior cortical hypoperfusion could be used as an additional neuronal injury biomarker in AD. Discussion : The specific combination of CSF markers and ¹⁸F‐PI‐2620 tau‐PET in disease‐specific regions facilitates the biomarker‐guided stratification of AD and 4RTs. This has implications for biomarker‐aided diagnostic workflows and the advancement in clinical trials. Highlights Novel biomarker‐based algorithm for differentiating AD and 4R‐tauopathies. A combination of CSF p‐tau181 and ¹⁸F‐PI‐2620 discriminates AD versus 4R tauopathies. Hypoperfusion serves as an additional neuronal injury biomarker in AD.

• Item Type: Journal article
• Faculties: Medicine > Munich Cluster for Systems Neurology (SyNergy); Medicine > Institute for Stroke and Dementia Research (ISD); Medicine > Medical Center of the University of Munich > Neurological Clinic and Polyclinic with Friedrich Baur Institute; Medicine > Medical Center of the University of Munich > Clinic and Polyclinic for Nuclear Medicine; Medicine > Medical Center of the University of Munich > Clinic and Polyclinic for Psychiatry and Psychotherapy; Medicine > Medical Center of the University of Munich > Clinic and Polyclinic for Radiology
• Subjects: 600 Technology > 610 Medicine and health
• ISSN: 1552-5260
• Language: English
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 390857198