Cited by 229Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsCerebrospinal fluid and hydrocephalus

Time course of phosphorylated-tau181 in blood across the Alzheimer’s disease spectrum

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Moscoso, Alexis, Grothe, Michel J, Ashton, Nicholas J, Karikari, Thomas K, Rodriguez, Juan Lantero, Snellman, Anniina, Suárez-Calvet, Marc, Zetterberg, Henrik +3 more·2021·Brain

Published version of a preprint

Abstract

Tau phosphorylated at threonine 181 (p-tau181) measured in blood plasma has recently been proposed as an accessible, scalable, and highly specific biomarker for Alzheimer’s disease. Longitudinal studies, however, investigating the temporal dynamics of this novel biomarker are lacking. It is therefore unclear when in the disease process plasma p-tau181 increases above physiological levels and how it relates to the spatiotemporal progression of Alzheimer’s disease characteristic pathologies. We aimed to establish the natural time course of plasma p-tau181 across the sporadic Alzheimer’s disease spectrum in comparison to those of established imaging and fluid-derived biomarkers of Alzheimer’s disease. We examined longitudinal data from a large prospective cohort of elderly individuals enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (n = 1067) covering a wide clinical spectrum from normal cognition to dementia, and with measures of plasma p-tau181 and an 18F-florbetapir amyloid-β PET scan at baseline. A subset of participants (n = 864) also had measures of amyloid-β1–42 and p-tau181 levels in CSF, and another subset (n = 298) had undergone an 18F-flortaucipir tau PET scan 6 years later. We performed brain-wide analyses to investigate the associations of plasma p-tau181 baseline levels and longitudinal change with progression of regional amyloid-β pathology and tau burden 6 years later, and estimated the time course of changes in plasma p-tau181 and other Alzheimer’s disease biomarkers using a previously developed method for the construction of long-term biomarker temporal trajectories using shorter-term longitudinal data. Smoothing splines demonstrated that earliest plasma p-tau181 changes occurred even before amyloid-β markers reached abnormal levels, with greater rates of change correlating with increased amyloid-β pathology. Voxel-wise PET analyses yielded relatively weak, yet significant, associations of plasma p-tau181 with amyloid-β pathology in early accumulating brain regions in cognitively healthy individuals, while the strongest associations with amyloid-β were observed in late accumulating regions in patients with mild cognitive impairment. Cross-sectional and particularly longitudinal measures of plasma p-tau181 were associated with widespread cortical tau aggregation 6 years later, covering temporoparietal regions typical for neurofibrillary tangle distribution in Alzheimer’s disease. Finally, we estimated that plasma p-tau181 reaches abnormal levels ∼6.5 and 5.7 years after CSF and PET measures of amyloid-β, respectively, following similar dynamics as CSF p-tau181. Our findings suggest that plasma p-tau181 increases are associated with the presence of widespread cortical amyloid-β pathology and with prospective Alzheimer’s disease typical tau aggregation, providing clear implications for the use of this novel blood biomarker as a diagnostic and screening tool for Alzheimer’s disease.

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  • Plasma p-tau-181 and plasma p-tau 217 may be useful in trials to assess impact on tau pathology of trial participants.

    “Plasma p‐tau‐181 and plasma p‐tau 217 are elevated as AD advances and may be useful in trials to assess impact on tau pathology of trial participants. 28 , 29”

    From Alzheimer’s disease drug development pipeline: 2021 (2021) · cites this paper as [28]

  • Plasma p-tau-181 and plasma p-tau 217 are elevated as AD advances.

    “Plasma p‐tau‐181 and plasma p‐tau 217 are elevated as AD advances and may be useful in trials to assess impact on tau pathology of trial participants. 28 , 29”

    From Alzheimer’s disease drug development pipeline: 2021 (2021) · cites this paper as [28]

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Authors
Moscoso, A., Grothe, M. J., Ashton, N. J., Karikari, T. K., Rodriguez, J. L., Snellman, A., Suárez-Calvet, M., Zetterberg, H., Blennow, K., Schöll, M., & Initiative, F. T. A. D. N.
Affiliations
  • Wallenberg Centre for Molecular and Translational Medicine (SE)
  • Instituto de Biomedicina de Sevilla (ES)
  • King's College London (GB)
  • University of Gothenburg (SE)
  • Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
  • University of Turku (FI)
  • Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
  • Sahlgrenska University Hospital (SE)
  • UCL Queen Square Institute of Neurology (GB)
Corresponding author
Schöll, Michael
Venue
Brain
Published
2020-11-30
Volume
144
Issue
1
Pages
325-339
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
OpenAlex
W3107511586
Cited by
229
References
75
Citations by year
2026: 16 · 2025: 31 · 2024: 42 · 2023: 46 · 2022: 54 · 2021: 38 · 2020: 1
FWCI
25.36
Type
journal article
Language
en
Open access
Locations
  • Brain (publishedVersion, cc-by-nc)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Repositori digital de la UPF (Universitat Pompeu Fabra) (publishedVersion, cc-by-nc)
  • RISalud Institutional Health Repository of Andalucía (submittedVersion, cc-by-nc)
  • UTUPub (University of Turku) (submittedVersion)
  • DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion, cc-by-nc)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • “Miguel Servet” program (CP19/00031)
  • Spanish Instituto de Salud Carlos III
  • Brightfocus Foundation (#A2020812F)
  • Swedish Alzheimer Foundation (#AF-930627, #AF-742881, #AF-740191)
  • Swedish Brain Foundation (#FO2020-0240)
  • Swedish Dementia Foundation
  • Agneta Prytz-Folkes & Gösta Folkes Foundation (#2020-00124)
  • Wallströms and Mary-Ann Sjöbloms Foundation
  • Anna Lisa and Brother Björnsson’s Foundation
  • Gamla Tjänarinnor
  • Gun and Bertil Stohnes Foundation
  • Paulo Foundation
  • Orion Research Foundation
  • European Union’s Horizon 2020 Research and Innovation Program (752310)
  • Instituto de Salud Carlos III (PI19/00155)
  • Spanish Ministry of Science, Innovation and Universities (IJC2018-037478-I)
  • Swedish Research Council (#2018-02532, #2017-00915, #2017-02869)
  • European Research Council (#681712)
  • Swedish State Support for Clinical Research (#ALFGBG-720931)
  • Alzheimer Drug Discovery Foundation (#201809-2016862, #RDAPB-201809-2016615)
  • Hjärnfonden (#FO2017-0243)
  • ALF-agreement (#ALFGBG-715986, #ALFGBG-813971)
  • European Union Joint Program for Neurodegenerative Disorders (JPND2019-466-236)
  • Knut and Alice Wallenberg Foundation (KAW 2014.0363)
  • National Institutes of Health (U01 AG024904)
  • Department of Defense award (W81XWH-12-2-0012)
  • National Institute of Biomedical Imaging and Bioengineering
  • AbbVie
  • Alzheimer’s Association
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
Keywords
plasma biomarkers, Alzheimer's disease, amyloid-beta pathology, tau PET, neurofibrillary tangles, mild cognitive impairment, longitudinal biomarker dynamics, cerebrospinal fluid biomarkers, amyloid-beta 42, disease progression, ADNI cohort, smoothing splines
MeSH terms
Alzheimer Disease, Brain, Humans, Longitudinal Studies, Phosphorylation, Prospective Studies, Threonine, Biomarkers, tau Proteins, Disease Progression, Positron-Emission Tomography

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