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Is plasma p-tau217 as useful as CSF for Alzheimer PET positivity?

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In 114 Geneva memory-clinic patients, plasma p-tau217 identified amyloid/tau PET positivity (mean AUC 0.96) better than p-tau181/231 and similarly to CSF p-tau217 (AUC 0.95).

Source

Head-to-head study of diagnostic accuracy of plasma and cerebrospinal fluid p-tau217 versus p-tau181 and p-tau231 in a memory clinic cohort

Mendes AJ, Ribaldi F, Lathuiliere A, et al. · Journal of neurology · 2024

doi.org/10.1007/s00415-023-12148-5Read the full paper ↗90 citationscc by

Study at a glance

Design
Cross-sectional — Head-to-head diagnostic-accuracy study of plasma and CSF p-tau217 vs p-tau181 and p-tau231 against amyloid- and tau-PET in a Geneva memory-clinic cohort.
N
N=114 · 114 participants (CU 33, MCI 67, dementia 14); CSF subset n=36.
Population
Memory-clinic patients at Geneva University Hospitals spanning cognitively unimpaired, MCI, and dementia.
Outcome
Correlation with A/T-PET, group effect sizes, and ROC AUC for amyloid- and tau-PET positivity.

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

Correlated plasma and CSF p-tau217/181/231 with continuous amyloid- and tau-PET, compared effect sizes across diagnosis and A/T groups, and ran ROC analyses for PET positivity.

What they found

Plasma/CSF p-tau217 correlated more strongly with A- and T-PET (r 0.64–0.83) than p-tau181 or p-tau231. Plasma p-tau217 had larger group δ (0.55–0.96) and mean AUC 0.96 vs 0.76 (181) and 0.79 (231). CSF p-tau217 AUC 0.95 did not significantly beat CSF 181/231 (0.88/0.89). Authors conclude plasma p-tau217 performed like CSF and could reduce invasive testing.

The limits

What it doesn't show

CSF n=36 is too small for a firm plasma-vs-CSF contest, and cohort-specific cut-offs plus a single memory clinic limit transportability.

Key terms

p-tau217
Tau phosphorylated at threonine 217; best plasma marker here for A/T-PET.
p-tau181 / p-tau231
Comparator phospho-tau epitopes with lower plasma AUCs in this cohort.
A-PET / T-PET
Amyloid and tau positron-emission tomography used as imaging standards.
AUC
Area under the ROC curve for PET positivity; plasma p-tau217 mean AUC 0.96.
MCI
Mild cognitive impairment; 67 of 114 participants.
Simoa / MSD
Homebrew Simoa (181/231) and Lilly MSD immunoassay (217) platforms.

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Memory-clinic n was:

Common questions

How many participants?

114 (33 cognitively unimpaired, 67 MCI, 14 dementia).

Plasma p-tau217 mean AUC vs PET?

0.96, versus 0.76 (181) and 0.79 (231).

Did CSF p-tau217 beat other CSF epitopes?

Not significantly (AUC 0.95 vs 0.88 and 0.89).

Main CSF limitation?

Only 36 people had CSF, limiting plasma–CSF comparison.

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