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Baiardi S, Quadalti C, Mammana A, Dellavalle S, Zenesini C, Sambati L, Pantieri R, Polischi B, Romano L, Suffritti M, Bentivenga GM, Randi V, Stanzani-Maserati M, Capellari S, Parchi P. Diagnostic value of plasma p-tau181, NfL, and GFAP in a clinical setting cohort of prevalent neurodegenerative dementias. Alzheimers Res Ther 2022; 14:153. [PMID: 36221099 PMCID: PMC9555092 DOI: 10.1186/s13195-022-01093-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
Background Increasing evidence supports the use of plasma biomarkers of neurodegeneration and neuroinflammation to screen and diagnose patients with dementia. However, confirmatory studies are required to demonstrate their usefulness in the clinical setting. Methods We evaluated plasma and cerebrospinal fluid (CSF) samples from consecutive patients with frontotemporal dementia (FTD) (n = 59), progressive supranuclear palsy (PSP) (n = 31), corticobasal syndrome (CBS) (n = 29), dementia with Lewy bodies (DLB) (n = 49), Alzheimer disease (AD) (n = 97), and suspected non-AD physiopathology (n = 51), as well as plasma samples from 60 healthy controls (HC). We measured neurofilament light chain (NfL), phospho-tau181 (p-tau181), and glial fibrillary acid protein (GFAP) using Simoa (all plasma biomarkers and CSF GFAP), CLEIA (CSF p-tau181), and ELISA (CSF NfL) assays. Additionally, we stratified patients according to the A/T/N classification scheme and the CSF α-synuclein real-time quaking-induced conversion assay (RT-QuIC) results. Results We found good correlations between CSF and plasma biomarkers for NfL (rho = 0.668, p < 0.001) and p-tau181 (rho = 0.619, p < 0.001). Plasma NfL was significantly higher in disease groups than in HC and showed a greater increase in FTD than in AD [44.9 (28.1–68.6) vs. 21.9 (17.0–27.9) pg/ml, p < 0.001]. Conversely, plasma p-tau181 and GFAP levels were significantly higher in AD than in FTD [3.2 (2.4–4.3) vs. 1.1 (0.7–1.6) pg/ml, p < 0.001; 404.7 (279.7–503.0) vs. 198.2 (143.9–316.8) pg/ml, p < 0.001]. GFAP also allowed discriminating disease groups from HC. In the distinction between FTD and AD, plasma p-tau181 showed better accuracy (AUC 0.964) than NfL (AUC 0.791) and GFAP (AUC 0.818). In DLB and CBS, CSF amyloid positive (A+) subjects had higher plasma p-tau181 and GFAP levels than A− individuals. CSF RT-QuIC showed positive α-synuclein seeding activity in 96% DLB and 15% AD patients with no differences in plasma biomarker levels in those stratified by RT-QuIC result. Conclusions In a single-center clinical cohort, we confirm the high diagnostic value of plasma p-tau181 for distinguishing FTD from AD and plasma NfL for discriminating degenerative dementias from HC. Plasma GFAP alone differentiates AD from FTD and neurodegenerative dementias from HC but with lower accuracy than p-tau181 and NfL. In CBS and DLB, plasma p-tau181 and GFAP levels are significantly influenced by beta-amyloid pathology. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01093-6.
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Affiliation(s)
- Simone Baiardi
- grid.6292.f0000 0004 1757 1758Department of Experimental, Diagnostic and Specialty Medicine (DIMES) University of Bologna, Bologna, Italy ,grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Corinne Quadalti
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Angela Mammana
- grid.6292.f0000 0004 1757 1758Department of Experimental, Diagnostic and Specialty Medicine (DIMES) University of Bologna, Bologna, Italy ,grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Sofia Dellavalle
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Corrado Zenesini
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Luisa Sambati
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Roberta Pantieri
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Barbara Polischi
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy
| | - Luciano Romano
- grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences University of Bologna (DIBINEM), Bologna, Italy
| | - Matteo Suffritti
- grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences University of Bologna (DIBINEM), Bologna, Italy
| | - Giuseppe Mario Bentivenga
- grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences University of Bologna (DIBINEM), Bologna, Italy
| | - Vanda Randi
- Emilia-Romagna Regional Blood Bank, Immunohematology and Transfusion Medicine Service, Bologna Metropolitan Area, Bologna, Italy
| | | | - Sabina Capellari
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy ,grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences University of Bologna (DIBINEM), Bologna, Italy
| | - Piero Parchi
- grid.492077.fIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 1/8, 40139 Bologna, Italy ,grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences University of Bologna (DIBINEM), Bologna, Italy
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