1. A three-range approach enhances the prognostic utility of CSF biomarkers in Alzheimer's disease
- Author
-
Wagner S, Brum, Marco Antônio, de Bastiani, Andrei, Bieger, Joseph, Therriault, João P, Ferrari-Souza, Andréa L, Benedet, Paramita, Saha-Chaudhuri, Diogo O, Souza, Nicholas J, Ashton, Henrik, Zetterberg, Tharick A, Pascoal, Thomas, Karikari, Kaj, Blennow, Pedro, Rosa-Neto, and Eduardo R, Zimmer
- Subjects
Psychiatry and Mental health ,Neurology (clinical) - Abstract
Alzheimer's disease consensus recommends biomarker dichotomization, a practice with well-described clinical strengths and methodological limitations. Although neuroimaging studies have explored alternative biomarker interpretation strategies, a formally defined three-range approach and its prognostic impact remains under-explored for cerebrospinal fluid (CSF) biomarkers .With two-graph receiver-operating characteristics based on different reference schemes, we derived three-range cut-points for CSF Elecsys biomarkers. According to baseline CSF status, we assessed the prognostic utility of this in predicting risk of clinical progression and longitudinal trajectories of cognitive decline and amyloid-beta (Aβ) positron emission tomography (PET) accumulation in non-demented individuals (Alzheimer's Disease Neuroimaging Initiative [ADNI]; n = 1246). In all analyses, we compared herein-derived three-range CSF cut-points to previously described binary ones.In our main longitudinal analyses, we highlight CSF p-tauThe proposed approach can refine clinico-biological prognostic assessment and potentially enhance trial recruitment, as it captures faster biomarker-related cognitive decline in comparison to binary cut-points. Although this approach has implications for trial recruitment and observational studies, further discussion is needed regarding clinical practice applications.
- Published
- 2021