%0 Journal Article
%A Biel, Davina
%A Steward, Anna
%A Dewenter, Anna
%A Dehsarvi, Amir
%A Zhu, Zeyu
%A Roemer-Cassiano, Sebastian N
%A Frontzkowski, Lukas
%A Hirsch, Fabian
%A Palleis, Carla
%A Höglinger, Günter
%A Brendel, Matthias
%A Franzmeier, Nicolai
%T A systematic comparison of ATN biomarkers for monitoring longitudinal cognitive changes in Alzheimer's disease
%J Alzheimer's and dementia
%V 21
%N 10
%@ 1552-5260
%C Hoboken, NJ
%I Wiley
%M DZNE-2025-01188
%P e70783
%D 2025
%X INTRODUCTIONWith anti-amyloid beta (Aβ) therapies approved for Alzheimer's disease (AD), surrogate biomarkers are needed to monitor clinical treatment efficacy. Therefore, we systematically compared longitudinal changes in A/T/N biomarkers (amyloid-positron emission tomography [PET], tau-PET, plasma phosphorylated tau at threonine 217 [p-tau217], and magnetic resonance imaging) for tracking cognitive changes.METHODSWe analyzed longitudinal biomarker and cognitive change rates from the Alzheimer's Disease Neuroimaging Initiative (N = 141) and Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) (N = 151), estimated using linear mixed models. Using linear models, we tested biomarker changes as predictors of cognitive changes, comparing predictive strengths across biomarkers using bootstrapping.RESULTSTau-PET, plasma p-tau217, and cortical thickness changes accurately tracked change rates in Mini-Mental State Examination, Alzheimer's Disease Assessment Scale-Cognitive Subscale 13-item version, Clinical Dementia Rating-Sum of Boxes, and Preclinial Alzheimer Cognitive Composite scores. In contrast, amyloid-PET change rates were not linked to cognitive changes.DISCUSSIONPlasma p-tau217 offers a cost-effective AD-specific alternative to tau-PET and could potentially be implemented for monitoring cognitive changes in AD trials, while amyloid-PET lacks utility. Cortical thickness changes accurately track cognitive changes but may be confounded by pseudo-atrophy in anti-Aβ treatments.
%F PUB:(DE-HGF)16
%9 Journal Article
%R 10.1002/alz.70783
%U https://pub.dzne.de/record/281802