Differential diagnostic performance of a panel of plasma biomarkers for different types of dementia
Elisabeth H. Thijssen, Inge M.W. Verberk, Jana Kindermans, Adlin Abramian, Jeroen Vanbrabant, Andrew J. Ball, Yolande A.L. Pijnenburg, Afina W. Lemstra, Wiesje M. van der Flier, Erik Stoops, Christophe Hirtz, Charlotte E. Teunissen
Abstract
Abstract Introduction We explored what combination of blood‐based biomarkers (amyloid beta [Aβ] 1‐42/1‐40 , phosphorylated tau [p‐tau]181, neurofilament light [NfL], glial fibrillary acidic protein [GFAP]) differentiates Alzheimer's disease (AD) dementia, frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB). Methods We measured the biomarkers with Simoa in two separate cohorts (n = 160 and n = 152). In one cohort, Aβ 1‐42/1‐40 was also measured with mass spectrometry (MS). We assessed the differential diagnostic value of the markers, by logistic regression with Wald's backward selection. Results MS and Simoa Aβ 1‐42/1‐40 similarly differentiated AD from controls. The Simoa panel that optimally differentiated AD from FTD consisted of NfL and p‐tau181 (area under the curve [AUC] = 0.94; cohort 1) or NfL, GFAP, and p‐tau181 (AUC = 0.90; cohort 2). For AD from DLB, the panel consisted of NfL, p‐tau181, and GFAP (AUC = 0.88; cohort 1), and only p‐tau181 (AUC = 0.81; cohort 2). Discussion A combination of plasma p‐tau181, NfL, and GFAP, but not Aβ 1‐42/1‐40 , might be useful to discriminate AD, FTD, and DLB.