Plasma phosphorylated tau181 outperforms [<scp><sup>18</sup>F</scp>] <scp>fluorodeoxyglucose positron emission tomography</scp> in the identification of early Alzheimer disease
Bibliographic record
Abstract
Abstract Background and purpose This study was undertaken to compare the performance of plasma p‐tau181 with that of [ 18 F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in the identification of early biological Alzheimer disease (AD). Methods We included 533 cognitively impaired participants from the Alzheimer's Disease Neuroimaging Initiative. Participants underwent PET scans, biofluid collection, and cognitive tests. Receiver operating characteristic analyses were used to determine the diagnostic accuracy of plasma p‐tau181 and [ 18 F]FDG‐PET using clinical diagnosis and core AD biomarkers ([ 18 F]florbetapir‐PET and cerebrospinal fluid [CSF] p‐tau181) as reference standards. Differences in the diagnostic accuracy between plasma p‐tau181 and [ 18 F]FDG‐PET were determined by bootstrap‐based tests. Correlations of [ 18 F]FDG‐PET and plasma p‐tau181 with CSF p‐tau181, amyloid β (Aβ) PET, and cognitive performance were evaluated to compare associations between measurements. Results We observed that both plasma p‐tau181 and [ 18 F]FDG‐PET identified individuals with positive AD biomarkers in CSF or on Aβ‐PET. In the MCI group, plasma p‐tau181 outperformed [ 18 F]FDG‐PET in identifying AD measured by CSF ( p = 0.0007) and by Aβ‐PET ( p = 0.001). We also observed that both plasma p‐tau181 and [ 18 F]FDG‐PET metabolism were associated with core AD biomarkers. However, [ 18 F]FDG‐PET uptake was more closely associated with cognitive outcomes (Montreal Cognitive Assessment, Mini‐Mental State Examination, Clinical Dementia Rating Sum of Boxes, and logical memory delayed recall, p < 0.001) than plasma p‐tau181. Conclusions Overall, although both plasma p‐tau181 and [ 18 F]FDG‐PET were associated with core AD biomarkers, plasma p‐tau181 outperformed [ 18 F]FDG‐PET in identifying individuals with early AD pathophysiology. Taken together, our study suggests that plasma p‐tau181 may aid in detecting individuals with underlying early AD.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".