We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Tau Positron Emission Tomography for Predicting Dementia in Individuals With Mild Cognitive Impairment.
- Authors
Groot, Colin; Smith, Ruben; Collij, Lyduine E.; Mastenbroek, Sophie E.; Stomrud, Erik; Binette, Alexa Pichet; Leuzy, Antoine; Palmqvist, Sebastian; Mattsson-Carlgren, Niklas; Strandberg, Olof; Cho, Hanna; Lyoo, Chul Hyoung; Frisoni, Giovanni B.; Peretti, Debora E.; Garibotto, Valentina; La Joie, Renaud; Soleimani-Meigooni, David N.; Rabinovici, Gil; Ossenkoppele, Rik; Hansson, Oskar
- Abstract
Key Points: Question: How well do visual reads and quantitative assessments of tau positron emission tomography (PET) predict clinical progression from mild cognitive impairment (MCI) to dementia compared to amyloid-β (Aβ) PET and magnetic resonance imaging (MRI)? Findings: In this cohort study, positivity on quantitative tau PET, but not Aβ PET or MRI, provided a better prediction of conversion from MCI to all-cause dementia when added to a base model including age, sex, education, and Mini-Mental State Examination score, while prediction of Alzheimer disease (AD) dementia was improved with quantitative tau PET as well as tau PET visual reads. The optimal set of neuroimaging biomarkers to predict all-cause and AD dementia included tau PET and MRI measures. Meaning: These findings suggest that quantitative tau PET and tau PET visual reads show the greatest promise as a stand-alone prognostic marker for clinical progression to dementia among individuals with MCI, outperforming Aβ PET and MRI. This cohort study evaluates the use of tau positron emission tomography in estimating risk of progression to dementia in individuals with mild cognitive impairment. Importance: An accurate prognosis is especially pertinent in mild cognitive impairment (MCI), when individuals experience considerable uncertainty about future progression. Objective: To evaluate the prognostic value of tau positron emission tomography (PET) to predict clinical progression from MCI to dementia. Design, Setting, and Participants: This was a multicenter cohort study with external validation and a mean (SD) follow-up of 2.0 (1.1) years. Data were collected from centers in South Korea, Sweden, the US, and Switzerland from June 2014 to January 2024. Participant data were retrospectively collected and inclusion criteria were a baseline clinical diagnosis of MCI; longitudinal clinical follow-up; a Mini-Mental State Examination (MMSE) score greater than 22; and available tau PET, amyloid-β (Aβ) PET, and magnetic resonance imaging (MRI) scan less than 1 year from diagnosis. A total of 448 eligible individuals with MCI were included (331 in the discovery cohort and 117 in the validation cohort). None of these participants were excluded over the course of the study. Exposures: Tau PET, Aβ PET, and MRI. Main Outcomes and Measures: Positive results on tau PET (temporal meta–region of interest), Aβ PET (global; expressed in the standardized metric Centiloids), and MRI (Alzheimer disease [AD] signature region) was assessed using quantitative thresholds and visual reads. Clinical progression from MCI to all-cause dementia (regardless of suspected etiology) or to AD dementia (AD as suspected etiology) served as the primary outcomes. The primary analyses were receiver operating characteristics. Results: In the discovery cohort, the mean (SD) age was 70.9 (8.5) years, 191 (58%) were male, the mean (SD) MMSE score was 27.1 (1.9), and 110 individuals with MCI (33%) converted to dementia (71 to AD dementia). Only the model with tau PET predicted all-cause dementia (area under the receiver operating characteristic curve [AUC], 0.75; 95% CI, 0.70-0.80) better than a base model including age, sex, education, and MMSE score (AUC, 0.71; 95% CI, 0.65-0.77; P =.02), while the models assessing the other neuroimaging markers did not improve prediction. In the validation cohort, tau PET replicated in predicting all-cause dementia. Compared to the base model (AUC, 0.75; 95% CI, 0.69-0.82), prediction of AD dementia in the discovery cohort was significantly improved by including tau PET (AUC, 0.84; 95% CI, 0.79-0.89; P <.001), tau PET visual read (AUC, 0.83; 95% CI, 0.78-0.88; P =.001), and Aβ PET Centiloids (AUC, 0.83; 95% CI, 0.78-0.88; P =.03). In the validation cohort, only the tau PET and the tau PET visual reads replicated in predicting AD dementia. Conclusions and Relevance: In this study, tau-PET showed the best performance as a stand-alone marker to predict progression to dementia among individuals with MCI. This suggests that, for prognostic purposes in MCI, a tau PET scan may be the best currently available neuroimaging marker.
- Publication
JAMA Neurology, 2024, Vol 81, Issue 8, p845
- ISSN
2168-6149
- Publication type
Article
- DOI
10.1001/jamaneurol.2024.1612