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Schindler SE, Karikari TK, Ashton NJ, Henson RL, Yarasheski KE, West T, Meyer MR, Kirmess KM, Li Y, Saef B, Moulder KL, Bradford D, Fagan AM, Gordon BA, Benzinger TLS, Balls-Berry J, Bateman RJ, Xiong C, Zetterberg H, Blennow K, Morris JC. Effect of Race on Prediction of Brain Amyloidosis by Plasma Aβ42/Aβ40, Phosphorylated Tau, and Neurofilament Light. Neurology 2022; 99:e245-e257. [PMID: 35450967 PMCID: PMC9302933 DOI: 10.1212/wnl.0000000000200358] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/22/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To evaluate whether plasma biomarkers of amyloid (Aβ42/Aβ40), tau (p-tau181 and p-tau231), and neuroaxonal injury (neurofilament light chain [NfL]) detect brain amyloidosis consistently across racial groups. METHODS Individuals enrolled in studies of memory and aging who self-identified as African American (AA) were matched 1:1 to self-identified non-Hispanic White (NHW) individuals by age, APOE ε4 carrier status, and cognitive status. Each participant underwent blood and CSF collection, and amyloid PET was performed in 103 participants (68%). Plasma Aβ42/Aβ40 was measured by a high-performance immunoprecipitation-mass spectrometry assay. Plasma p-tau181, p-tau231, and NfL were measured by Simoa immunoassays. CSF Aβ42/Aβ40 and amyloid PET status were used as primary and secondary reference standards of brain amyloidosis, respectively. RESULTS There were 76 matched pairs of AA and NHW participants (n = 152 total). For both AA and NHW groups, the median age was 68.4 years, 42% were APOE ε4 carriers, and 91% were cognitively normal. AA were less likely than NHW participants to have brain amyloidosis by CSF Aβ42/Aβ40 (22% vs 43% positive; p = 0.003). The receiver operating characteristic area under the curve of CSF Aβ42/Aβ40 status with the plasma biomarkers was as follows: Aβ42/Aβ40, 0.86 (95% CI 0.79-0.92); p-tau181, 0.76 (0.68-0.84); p-tau231, 0.69 (0.60-0.78); and NfL, 0.64 (0.55-0.73). In models predicting CSF Aβ42/Aβ40 status with plasma Aβ42/Aβ40 that included covariates (age, sex, APOE ε4 carrier status, race, and cognitive status), race did not affect the probability of CSF Aβ42/Aβ40 positivity. In similar models based on plasma p-tau181, p-tau231, or NfL, AA participants had a lower probability of CSF Aβ42/Aβ40 positivity (odds ratio 0.31 [95% CI 0.13-0.73], 0.30 [0.13-0.71], and 0.27 [0.12-0.64], respectively). Models of amyloid PET status yielded similar findings. DISCUSSION Models predicting brain amyloidosis using a high-performance plasma Aβ42/Aβ40 assay may provide an accurate and consistent measure of brain amyloidosis across AA and NHW groups, but models based on plasma p-tau181, p-tau231, and NfL may perform inconsistently and could result in disproportionate misdiagnosis of AA individuals.
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Affiliation(s)
- Suzanne E Schindler
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China.
| | - Thomas K Karikari
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Nicholas J Ashton
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Rachel L Henson
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Kevin E Yarasheski
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Tim West
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Mathew R Meyer
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Kristopher M Kirmess
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Yan Li
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Benjamin Saef
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Krista L Moulder
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - David Bradford
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Anne M Fagan
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Brian A Gordon
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Tammie L S Benzinger
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Joyce Balls-Berry
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Randall J Bateman
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Chengjie Xiong
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Henrik Zetterberg
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - Kaj Blennow
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
| | - John C Morris
- From the Department of Neurology (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., J.B.-B., R.J.B., J.C.M), Knight Alzheimer Disease Research Center (S.E.S., R.L.H., Y.L., B.S., K.L.M., D.B., A.M.F., B.A.G., T.L.S.B., J.B.-B., R.J.B., C.X., J.C.M.), Hope Center for Neurological Disorders (A.M.F.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Division of Biostatistics (C.X.), Washington University School of Medicine, St. Louis, MO; Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry (T.K.K., N.J.A., H.Z., K.B.), Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden; Department of Psychiatry (T.K.K.), University of Pittsburgh, PA; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Sweden; Institute of Psychiatry, Psychology and Neuroscience (N.J.A.), Maurice Wohl Institute Clinical Neuroscience Institute, King's College London,; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), London, UK; C2N Diagnostics (K.E.Y., T.W., M.R.M., K.M.K.), St. Louis, MO; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square, London,; UK Dementia Research Institute at UCL (H.Z.), London, UK; and Hong Kong Center for Neurodegenerative Diseases (H.Z.), China
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