%0 Journal Article
%A Biel, Davina
%A Brendel, Matthias
%A Rubinski, Anna
%A Bürger, Katharina
%A Janowitz, Daniel
%A Dichgans, Martin
%A Franzmeier, Nicolai
%T Tau-PET and in vivo Braak-staging as prognostic markers of future cognitive decline in cognitively normal to demented individuals.
%J Alzheimer's research & therapy
%V 13
%N 1
%@ 1758-9193
%C London
%I BioMed Central
%M DZNE-2021-01362
%P 137
%D 2021
%Z CC BY
%X To systematically examine the clinical utility of tau-PET and Braak-staging as prognostic markers of future cognitive decline in older adults with and without cognitive impairment.In this longitudinal study, we included 396 cognitively normal to dementia subjects with 18F-Florbetapir/18F-Florbetaben-amyloid-PET, 18F-Flortaucipir-tau-PET and   2-year cognitive follow-up. Annual change rates in global cognition (i.e., MMSE, ADAS13) and episodic memory were calculated via linear-mixed models. We determined global amyloid-PET (Centiloid) plus global and Braak-stage-specific tau-PET SUVRs, which were stratified as positive(+)/negative(-) at pre-established cut-offs, classifying subjects as Braak0/BraakI+/BraakI-IV+/BraakI-VI+/Braakatypical+. In bootstrapped linear regression, we assessed the predictive accuracy of global tau-PET SUVRs vs. Centiloid on subsequent cognitive decline. To test for independent tau vs. amyloid effects, analyses were further controlled for the contrary PET-tracer. Using ANCOVAs, we tested whether more advanced Braak-stage predicted accelerated future cognitive decline. All models were controlled for age, sex, education, diagnosis, and baseline cognition. Lastly, we determined Braak-stage-specific conversion risk to mild cognitive impairment (MCI) or dementia.Baseline global tau-PET SUVRs explained more variance (partial R2) in future cognitive decline than Centiloid across all cognitive tests (Cohen's d   2, all tests p < 0.001) and diagnostic groups. Associations between tau-PET and cognitive decline remained consistent when controlling for Centiloid, while associations between amyloid-PET and cognitive decline were non-significant when controlling for tau-PET. More advanced Braak-stage was associated with gradually worsening future cognitive decline, independent of Centiloid or diagnostic group (p < 0.001), and elevated conversion risk to MCI/dementia.Tau-PET and Braak-staging are highly predictive markers of future cognitive decline and may be promising single-modality estimates for prognostication of patient-specific progression risk in clinical settings.
%K Aged
%K Alzheimer Disease: complications
%K Alzheimer Disease: diagnostic imaging
%K Amyloid beta-Peptides
%K Cognitive Dysfunction: diagnostic imaging
%K Humans
%K Longitudinal Studies
%K Positron-Emission Tomography
%K Prognosis
%K tau Proteins
%K Alzheimer’s disease (Other)
%K Amyloid-PET (Other)
%K Braak-staging (Other)
%K Conversion risk (Other)
%K Tau-PET (Other)
%K Amyloid beta-Peptides (NLM Chemicals)
%K tau Proteins (NLM Chemicals)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:34384484
%2 pmc:PMC8361801
%R 10.1186/s13195-021-00880-x
%U https://pub.dzne.de/record/162705