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CSF biomarkers of Alzheimer's disease concord with amyloid‐β PET and predict clinical progression: A study of fully automated immunoassays in BioFINDER and ADNI cohorts
Open accessAbstract
Introduction: We studied whether fully automated Elecsys cerebrospinal fluid (CSF) immunoassay results were concordant with positron emission tomography (PET) and predicted clinical progression, even with cutoffs established in an independent cohort. Methods: Cutoffs for Elecsys amyloid‐β 1–42 (Aβ), total tau/Aβ(1–42), and phosphorylated tau/Aβ(1–42) were defined against [18 F]flutemetamol PET in Swedish BioFINDER (n = 277) and validated against [18 F]florbetapir PET in Alzheimer's Disease Neuroimaging Initiative (n = 646). Clinical progression in patients with mild cognitive impairment (n = 619) was studied. Results: CSF total tau/Aβ(1–42) and phosphorylated tau/Aβ(1–42) ratios were highly concordant with PET classification in BioFINDER (overall percent agreement: 90%; area under the curve: 94%). The CSF biomarker statuses established by predefined cutoffs were highly concordant with PET classification in Alzheimer's Disease Neuroimaging Initiative (overall percent agreement: 89%–90%; area under the curves: 96%) and predicted greater 2‐year clinical decline in patients with mild cognitive impairment. Strikingly, tau/Aβ ratios were as accurate as semiquantitative PET image assessment in predicting visual read–based outcomes. Discussion: Elecsys CSF biomarker assays may provide reliable alternatives to PET in Alzheimer's disease diagnosis.
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“For instance, the FDA-approved Elecsys CSF p-tau181/Aβ42 test has, in previous studies, classified Aβ PET status with overall accuracies of 89–90% (refs. 39–41), which was replicated in the present study.”
From Highly accurate blood test for Alzheimer's disease is similar or superior to clinical cerebrospinal fluid tests (2024) · cites this paper as [39]
Experimental — accuracy not yet measuredIn the citing paper
“An extracellular deposition of amyloid-β (Aβ) protein and aggregated form of hyper phosphorylated tau protein in the brain are two main pathological characteristics of AD [41].”
From Recent Advancements in Pathogenesis, Diagnostics and Treatment of Alzheimer’s Disease (2020) · cites this paper as [41]
In the citing paper
“For example, for the Elecsys immunoassays (Roche Diagnostics), it has been shown that CSF cutoffs established in one European cohort could be applied to another independent cohort in the United States to determine amyloid PET status with high accuracy.24”
From Performance of Fully Automated Plasma Assays as Screening Tests for Alzheimer Disease–Related β-Amyloid Status (2019) · cites this paper as [24]
In the citing paper
“Recently, fully automated immunoassays have been developed by several different vendors with improved reliability and precision for CSF Aβ and tau species.23,24,25”
From Performance of Fully Automated Plasma Assays as Screening Tests for Alzheimer Disease–Related β-Amyloid Status (2019) · cites this paper as [24]
In the citing paper
“This robust result is similar to what has been shown when using the Elecsys assays for CSF to establish a cutoff in one cohort and replicating it in a second cohort.24”
From Performance of Fully Automated Plasma Assays as Screening Tests for Alzheimer Disease–Related β-Amyloid Status (2019) · cites this paper as [24]
In the citing paper
“Plasma tau increased the AUC slightly, and provided a better model fit (ΔAIC –27), but clinically this is not comparable with the contribution CSF tau has combined with CSF Aβ42,24 and improved plasma tau assays are probably needed in the future, such as measurement of specifically phosphorylated tau,46 to increase the added value of plasma tau to plasma Aβ42 and Aβ40.”
From Performance of Fully Automated Plasma Assays as Screening Tests for Alzheimer Disease–Related β-Amyloid Status (2019) · cites this paper as [24]
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Self-citation
Metadata
- Authors
- Hansson, O., Seibyl, J., Stomrud, E., Zetterberg, H., Trojanowski, J. Q., Bittner, T., Lifke, V., Corradini, V., Eichenlaub, U., Batrla, R., Buck, K., Zink, K., Rabe, C., Blennow, K., Shaw, L. M., for the Swedish BioFINDER study group, & Initiative, A. D. N.
- Affiliations
- Lund University (SE)
- Institute for Neurodegenerative Disorders (US)
- Sahlgrenska University Hospital (SE)
- University of Pennsylvania (US)
- Former Employee of Roche Diagnostics GmbH Penzberg Germany
- Roche Diagnostics GmbH Penzberg Germany
- F. Hoffmann-La Roche AG (CH)
- Alzheimer’s Disease Neuroimaging Initiative (US)
- Corresponding author
- Hansson, Oskar
- Blennow, Kaj
- Shaw, Leslie M.
- ORCID
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2018-02-27
- Volume
- 14
- Issue
- 11
- Pages
- 1470-1481
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- PMC
- PMC6119541
- OpenAlex
- W2789976306
- Cited by
- 808
- References
- 45
- Citations by year
- 2026: 84 · 2025: 117 · 2024: 146 · 2023: 96 · 2022: 98 · 2021: 95 · 2020: 97 · 2019: 56 · 2018: 15
- FWCI
- 51.74
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Alzheimer s & Dementia (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion, cc-by-nc-nd)
- PubMed Central (acceptedVersion, cc-by-nc-nd)
- UCL Discovery (University College London) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Michael J. Fox Foundation for Parkinson's Research
- Eli Lilly and Company
- Göteborgs Universitet
- National Institutes of Health
- National Institute on Aging (P30AG010124)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Clinical Neurology › Cerebrospinal fluid and hydrocephalus
- Keywords
- Alzheimer's disease, cerebrospinal fluid biomarkers
- MeSH terms
- Aged, Alzheimer Disease, Aniline Compounds, Ethylene Glycols, Female, Humans, Immunoassay, Male, Cohort Studies, Biomarkers, Amyloid beta-Peptides, tau Proteins, Disease Progression, Radiopharmaceuticals, Positron-Emission Tomography, Automation, Laboratory, Cognitive Dysfunction
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