Plasma biomarkers for diagnosis and differentiation and their cognitive correlations in patients with Alzheimer’s disease
Bibliographic record
Abstract
Abstract Increasing evidence has shown the potential value of plasma biomarkers in Alzheimer’s disease diagnosis. This study aimed to determine the diagnostic and differential values of emerging plasma biomarkers for different types of dementia in a Chinese population and to explore their cognitive correlations. One hundred twenty patients with dementia, including 51 Alzheimer’s disease patients, 54 subcortical ischaemic vascular dementia (SIVD) patients and 15 frontotemporal lobar degeneration (FTLD) patients were recruited alongside 27 cognitively unimpaired (CU) control subjects. Global and domain-specific cognition was assessed in all participants by a battery of neuropsychological tests. Plasma amyloid-beta (Αβ)42, Aβ40 and total tau (in CU controls and Alzheimer’s disease patients) and phosphorylated tau at threonine-181 (P-tau181), neurofilament light (NfL) and glial fibrillar acidic protein (GFAP) levels (in all participants) were measured using the single-molecule array platform. The levels of all biomarkers differed between Alzheimer’s disease patients and CU controls, with P-tau181 and GFAP levels and the Aβ42/P-tau181 ratio best differentiating the two groups [area under the curve (AUC) = 0.966, 0.932 and 0.927, respectively]. P-tau181 and GFAP levels were greater in the Alzheimer’s disease group than in the other two patient groups and showed the best performance in distinguishing Alzheimer’s disease patients from SIVD (AUC = 0.922) and FTLD patients (AUC = 0.894), respectively. Moreover, compared with that in the CU group, the GFAP level was elevated in the SIVD group, and the NfL level was elevated in all patient groups. Compared with other single biomarkers, the plasma Aβ42/P-tau181 ratio correlated with broader cognitive domains, including global cognition [Mini-Mental Status Examination (MMSE), r = 0.314, P = 0.027; Montreal Cognitive Assessment (MoCA), r = 0.313, P = 0.043], memory (r = 0.339, P = 0.016), language (r = 0.333, P = 0.020), attention and information processing speed (r = 0.369, P = 0.008), executive function (r = 0.305, P = 0.031) and visuospatial function memory (r = 0.453, P = 0.001). P-tau181 was an optimal plasma biomarker for identifying Alzheimer’s disease patients and differentiating Alzheimer’s disease patients from SIVD and FTLD patients. Moreover, the GFAP level and the Aβ42/P-tau181 ratio showed potential diagnostic and progression monitoring value, respectively, for Alzheimer’s disease patients.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".