Cell-weighted polygenic risk scores are associated with ฮฒ-amyloid and tau biomarkers in Alzheimerโs disease
Kumar et al. report distinct cellular effects on measures of ฮฒ-amyloid and tau. Importantly, they also found cell-level genetic evidence for a role for mic
๐จNew publication in Brain Communications!
In this study led by Atul Kumar, we show that microglial cells play a key role in Alzheimer's disease, particularly in regulating changes in soluble tau, based on cell-type-specific genetic evidence.
๐Full paper: academic.oup.com/braincomms/a...
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๐Many thanks to all collaborators in this large study including 12 international cohorts!
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๐ฏThe use of plasma p-tau217 will reduce resource demands and burdensome procedures accelerating the development and implementation of early AD therapeutics.
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5๏ธโฃ In conclusion, our results support the clinical utility of plasma p-tau217 as stand-alone tool for identifying preclinical AD but adding confirmatory CSF/PET would further improve PPVs as needed in many clinical applications.
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4๏ธโฃ Finally, in a subsample we tested whether mass-spectrometry (MS) based methods would improve the results compared to immunoassays (IA). MS showed significantly higher accuracy and sensitivity, but PPV remained comparable to that of IA.
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3๏ธโฃ In a hypothetical trial aiming to recruit 100 amyloid-positive individuals, there was >40% reduction in number of PET/CSF tests in blood-based approaches, although the initial number of individuals needed were increased.
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2๏ธโฃ Next, we investigated a 2-step approach in which ๐ฉธp-tau217 positive individuals were confirmed with CSF or PET.
With this approach, PPV increased to over 90% while maintaining sensitivity.
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1๏ธโฃ In a sample of 2916 cognitively unimpaired individuals we found that plasma p-tau217๐ฉธalone (single-step) was able to determine amyloid-b status with good accuracy and, most importantly, with a positive predictive value (PPV) around 80%.
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Plasma P-Tau217 to Identify Preclinical AD
This cohort study evaluates the use of plasma phosphorylated tau 217 in identifying preclinical Alzheimer disease in individuals with amyloid ฮฒ pathology.
๐จPaper alert๐จ
New publication in JAMA Neurology led by @gsalvado.bsky.social. In a multicentric study, we examined the clinical utility to assess preclinical #Alzheimerโs disease in cognitively unimpaired individuals.
jamanetwork.com/journals/jam...
A ๐งต...
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The study was led by PhD students Pontus Tideman and Linda Karlsson. Thank you also to all co-authors.
15.09.2025 13:23 โ ๐ 1 ๐ 0 ๐ฌ 0 ๐ 0
Big thanks to all co-authors and collaborators: @rikossenkoppele.bsky.social @aitchbi.bsky.social @jorittmo.bsky.social @jwvogel.bsky.social + those not on bksy
05.09.2025 14:39 โ ๐ 2 ๐ 0 ๐ฌ 0 ๐ 0
7/๐งต These results suggest that hemispheric difference in Aฮฒ deposition, rather than reduction in connectivity, is associated with asymmetric tau accumulation, highlighting regional vulnerability as a crucial factor in determining the distribution of AD pathology.
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6/๐งต More asymmetric tau accumulation was tied to faster cognitive decline, particularly in regions affected at later disease stages.
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5/๐งต Longitudinally, Aฮฒ asymmetry at baseline predicted subsequent increase in tau asymmetry over time, especially in participants who hadnโt yet developed neocortical tau deposits. The affected Braak regions depended on disease stage and progression.
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4/๐งต We replicated this Aฮฒ-tau asymmetry link across three independent cohorts (OASIS-3, A4, ADNI), showing it is a consistent feature throughout the AD continuum.
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3/๐งต There were no significant differences in inter-hemispheric connectivity (functional or structural) between asymmetric and symmetric tau groups. Instead, we observed a strong association between the laterality of Aฮฒ and tau pathology, especially in temporal regions.
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2/๐งต We assessed both inter-hemispheric brain connectivity (using RSfMRI and dMRI) and the spatial distribution of Aฮฒ in 452 A+T+ participants from the Swedish BioFINDER-2 cohort to investigate the differences between asymmetric and symmetric tau pathology distribution.
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1/๐งต In this study, we tried to disentangle whether tau asymmetry is due to reduction in inter-hemispheric brain connectivity (potentially restricting tau spread), or if it is linked to asymmetric amyloid-beta (Aฮฒ) deposition (indicating greater hemisphere-specific vulnerability to AD pathology).
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A huge thanks to all coauthors!
@josephtherr.bsky.social
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4๏ธโฃIn summary, we have developed a biomarker-based staging model using plasma tau biomarkers and validated in TRIAD. We believe these findings will enhance the application of blood tau biomarkers, improving patient management in both clinical trials and routine clinical practice.
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3๏ธโฃMost importantly, we also showed significant differences in longitudinal rates of change of several AD biomarkers.
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2๏ธโฃBased on the most sensitive of these markers, we developed a plasma-based staging system that showed good correlation with other AD biomarkers.
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1๏ธโฃIn brief, we showed that different plasma tau biomarkers were differently associated with different clinical stages of the disease.
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A huge thanks to all authors and collaborators who made this work possible!
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6/๐งตTaken together, we present an accurate two-step approach for predicting LBP in the brain using a smell test followed by CSF SAA testing in smell-test positive individuals. This could minimize costs, reduce patient burden, and improve the known underdiagnosis of DLB and PD.
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5/๐งตThese findings replicated to an in vivo cohort, where the smell-function test could predict CSF SAA status with 79% accuracy while reducing the required number of CSF tests by 26%.
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4/๐งตImportantly, this two-step approach worked well across multiple clinical scenarios, including individuals with clinical parkinsonism, those with an Alzheimer's-like presentation, and clinically unimpaired participants where it reduced the need of CSF testing by up to 80%.
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