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@ARTICLE{Yan:282539,
      author       = {Yan, Shijun and Sahoo, Anis and Zerenner, Tanja and Marek,
                      Kenneth and Sommerauer, Michael and Oertel, Wolfgang and Hu,
                      Michele T. and Tofaris, George K.},
      title        = {{S}erum p‐tau217 {I}s a {P}rognostic {I}ndicator of
                      {C}ognitive {I}mpairment in {I}diopathic {REM} {S}leep
                      {B}ehavior {D}isorder},
      journal      = {Annals of neurology},
      volume       = {AOP},
      issn         = {0364-5134},
      address      = {Hoboken, NJ},
      publisher    = {Wiley-Blackwell},
      reportid     = {DZNE-2025-01302},
      pages        = {ana.78109},
      year         = {2025},
      abstract     = {ObjectiveAssess the performance of serum phosphorylated tau
                      217 (p-tau217) and neurofilament light chain (NfL) in
                      predicting risk of cognitive impairment or phenoconversion
                      to dementia in individuals with iRBD.MethodsWe measured
                      serum p-tau217 and NfL levels by electrochemiluminescence
                      across 4 polysomnographically confirmed iRBD cohorts
                      (n = 300), including individuals who phenoconverted to
                      Parkinson's disease (PD) (n = 51), dementia with Lewy
                      bodies (DLB) (n = 22), and multiple system atrophy (MSA)
                      (n = 5).ResultsSerum p-tau217 levels were increased in
                      individuals with iRBD and cognitive impairment (CI) on
                      testing defined as Montreal Cognitive Assessment <26 or
                      subthreshold parkinsonism. p-Tau217 differentiated
                      individuals with iRBD who developed PD with CI (PD-CI) or
                      DLB from PD phenoconverters with normal cognition (area
                      under curve [AUC] = 0.82; $95\%$ confidence interval,
                      0.70–0.93) and from iRBD non-phenoconverters with normal
                      cognition (AUC = 0.83; $95\%$ confidence interval,
                      0.77–0.89). NfL levels did not correlate with cognitive or
                      motor scores and marginally improved p-tau217 performance
                      (AUC = 0.85; $95\%$ confidence interval, 0.78–0.92),
                      but were notably elevated in iRBD individuals who
                      phenoconverted to MSA. Individuals with p-tau217 in the top
                      quartile were 8 times more likely to phenoconvert to PD-CI
                      or DLB compared to the bottom quartile (hazard
                      ratio = 8.30; $95\%$ confidence interval,
                      2.49–27.65).InterpretationSerum p-tau217, but not NfL, is
                      a useful biomarker of cognitive impairment in iRBD that
                      could be integrated into a multimodal prognostic indicator
                      when stratifying risk of phenoconversion. ANN NEUROL 2025},
      cin          = {AG Petzold},
      ddc          = {610},
      cid          = {I:(DE-2719)1013020},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      doi          = {10.1002/ana.78109},
      url          = {https://pub.dzne.de/record/282539},
}