Prognostic Value of A/T/N Biomarkers: Comparing Plasma and Imaging Modalities in Alzheimer Disease.
Level 3 - non-randomized controlled study
Non-randomized longitudinal cohort study evaluating prognostic biomarkers.
PubMed 40910876 · doi:10.1097/RLU.0000000000006088
What was done
Longitudinal cohort study of K-ROAD participants who underwent at least two cognitive assessments. All 1,614 participants completed plasma biomarker testing (Aβ ratio, p-tau181, p-tau231, p-tau217, NfL), while a subset of 130 underwent imaging biomarker assessments (Aβ PET, tau PET, structural MRI). Multiple linear regression models were used to identify the most predictive biomarkers within each modality and evaluate the performance of combined A/T/N biomarkers in predicting cognitive decline.
What was found
The abstract reports no numerical values, effect sizes, or follow-up durations. Directionally, tau markers were the strongest predictors of cognitive decline across modalities: p-tau217 MSD outperformed other plasma biomarkers, and the neo-temporal ROI showed the highest predictive power among imaging biomarkers. Adding neurodegeneration markers improved the performance of plasma-based amyloid and tau models, but decreased performance in imaging-based models. Overall, imaging biomarkers (notably tau PET) showed superior prognostic accuracy compared to plasma biomarkers.
Why it matters
This study compares blood and imaging A/T/N biomarkers for predicting cognitive decline, indicating that while PET imaging remains more accurate, plasma models uniquely benefit from adding neurodegeneration markers.
Limits
The abstract contains no quantitative metrics or effect estimates. The imaging subcohort is relatively small (n = 130) compared to the plasma cohort (n = 1,614). Follow-up time, participant demographics, and specific cognitive tests are not specified in the abstract.
Cited by
- contradicts Low blood flow is the number one brain imaging predictor of Alzheimer's disease.