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Browsing by Author "Smith, Ruben"
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Item Amyloid-associated increases in soluble tau relate to tau aggregation rates and cognitive decline in early Alzheimer’s disease(Springer Nature, 2022-11-04) Pichet Binette, Alexa; Franzmeier, Nicolai; Spotorno, Nicola; Ewers, Michael; Brendel, Matthias; Biel, Davina; Alzheimer’s Disease Neuroimaging Initiative; Strandberg, Olof; Janelidze, Shorena; Palmqvist, Sebastian; Mattsson-Carlgren, Niklas; Smith, Ruben; Stomrud, Erik; Ossenkoppele, Rik; Hansson, Oskar; Radiology and Imaging Sciences, School of MedicineFor optimal design of anti-amyloid-β (Aβ) and anti-tau clinical trials, we need to better understand the pathophysiological cascade of Aβ- and tau-related processes. Therefore, we set out to investigate how Aβ and soluble phosphorylated tau (p-tau) relate to the accumulation of tau aggregates assessed with PET and subsequent cognitive decline across the Alzheimer's disease (AD) continuum. Using human cross-sectional and longitudinal neuroimaging and cognitive assessment data, we show that in early stages of AD, increased concentration of soluble CSF p-tau is strongly associated with accumulation of insoluble tau aggregates across the brain, and CSF p-tau levels mediate the effect of Aβ on tau aggregation. Further, higher soluble p-tau concentrations are mainly related to faster accumulation of tau aggregates in the regions with strong functional connectivity to individual tau epicenters. In this early stage, higher soluble p-tau concentrations is associated with cognitive decline, which is mediated by faster increase of tau aggregates. In contrast, in AD dementia, when Aβ fibrils and soluble p-tau levels have plateaued, cognitive decline is related to the accumulation rate of insoluble tau aggregates. Our data suggest that therapeutic approaches reducing soluble p-tau levels might be most favorable in early AD, before widespread insoluble tau aggregates.Item Associations of Plasma Phospho-Tau217 Levels With Tau Positron Emission Tomography in Early Alzheimer Disease(American Medical Association, 2021) Janelidze, Shorena; Berron, David; Smith, Ruben; Strandberg, Olof; Proctor, Nicholas K.; Dage, Jeffrey L.; Stomrud, Erik; Palmqvist, Sebastian; Mattsson-Carlgren, Niklas; Hansson, Oskar; Neurology, School of MedicineImportance: There is an urgent need for inexpensive and minimally invasive blood biomarkers for Alzheimer disease (AD) that could be used to detect early disease changes. Objective: To assess how early in the course of AD plasma levels of tau phosphorylated at threonine 217 (P-tau217) start to change compared with levels of established cerebrospinal fluid (CSF) and positron emission tomography (PET) biomarkers of AD pathology. Design, setting, and participants: This cohort study included cognitively healthy control individuals (n = 225) and participants with subjective cognitive decline (n = 89) or mild cognitive impairment (n = 176) from the BioFINDER-2 study. Participants were enrolled at 2 different hospitals in Sweden from January 2017 to October 2019. All study participants underwent plasma P-tau217 assessments and tau- and amyloid-β (Aβ)-PET imaging. A subcohort of 111 participants had 2 or 3 tau-PET scans. Main outcomes and measures: Changes in plasma P-tau217 levels in preclinical and prodromal AD compared with changes in CSF P-tau217 and PET measures. Results: Of 490 participants, 251 were women (51.2%) and the mean (SD) age was 65.9 (13.1) years. Plasma P-tau217 levels were increased in cognitively unimpaired participants with abnormal Aβ-PET but normal tau-PET in the entorhinal cortex (Aβ-PET+/ tau-PET- group vs Aβ-PET-/ tau-PET- group: median, 2.2 pg/mL [interquartile range (IQR), 1.5-2.9 pg/mL] vs 0.7 pg/mL [IQR, 0.3-1.4 pg/mL]). Most cognitively unimpaired participants who were discordant for plasma P-tau217 and tau-PET were positive for plasma P-tau217 and negative for tau-PET (P-tau217+/tau-PET-: 36 [94.7%]; P-tau217-/tau-PET+: 2 [5.3%]). Event-based modeling of cross-sectional data predicted that in cognitively unimpaired participants and in those with mild cognitive impairment, both plasma and CSF P-tau217 would change before the tau-PET signal in the entorhinal cortex, followed by more widespread cortical tau-PET changes. When testing the association with global Aβ load in nonlinear spline models, both plasma and CSF P-tau217 were increased at lower Aβ-PET values compared with tau-PET measures. Among participants with normal baseline tau-PET, the rates of longitudinal increase in tau-PET in the entorhinal cortex were higher in those with abnormal plasma P-tau217 at baseline (median standardized uptake value ratio, 0.029 [IQR, -0.006 to 0.041] vs -0.001 [IQR, -0.021 to 0.020]; Mann-Whitney U, P = .02). Conclusions and relevance: In this cohort study, plasma P-tau217 levels were increased during the early preclinical stages of AD when insoluble tau aggregates were not yet detectable by tau-PET. Plasma P-tau217 may hold promise as a biomarker for early AD brain pathology.Item Author Correction: Spread of pathological tau proteins through communicating neurons in human Alzheimer’s disease(Springer Nature, 2021-08-05) Vogel, Jacob W.; Iturria-Medina, Yasser; Strandberg, Olof T.; Smith, Ruben; Levitis, Elizabeth; Evans, Alan C.; Hansson, Oskar; Alzheimer’s Disease Neuroimaging Initiative; Swedish BioFinder Study; Radiology and Imaging Sciences, School of MedicineCorrection to: Nature Communications 10.1038/s41467-020-15701-2, published online 26 May 2020. The original version of the Supplementary information associated with this Article inadvertently omitted Supplementary Table S1. The HTML has been updated to include a corrected version of the Supplementary information.Item Soluble P‐tau217 reflects amyloid and tau pathology and mediates the association of amyloid with tau(EMBO Press, 2021) Mattsson-Carlgren, Niklas; Janelidze, Shorena; Bateman, Randall J.; Smith, Ruben; Stomrud, Erik; Serrano, Geidy E.; Reiman, Eric M.; Palmqvist, Sebastian; Dage, Jeffrey L.; Beach, Thomas G.; Hansson, Oskar; Neurology, School of MedicineAlzheimer's disease is characterized by β-amyloid plaques and tau tangles. Plasma levels of phospho-tau217 (P-tau217) accurately differentiate Alzheimer's disease dementia from other dementias, but it is unclear to what degree this reflects β-amyloid plaque accumulation, tau tangle accumulation, or both. In a cohort with post-mortem neuropathological data (N = 88), both plaque and tangle density contributed independently to higher P-tau217, but P-tau217 was not elevated in patients with non-Alzheimer's disease tauopathies (N = 9). Several findings were replicated in a cohort with PET imaging ("BioFINDER-2", N = 426), where β-amyloid and tau PET were independently associated with P-tau217. P-tau217 concentrations correlated with β-amyloid PET (but not tau PET) in early disease stages and with both β-amyloid and (more strongly) tau PET in late disease stages. Finally, P-tau217 mediated the association between β-amyloid and tau in both cohorts, especially for tau outside of the medial temporal lobe. These findings support the hypothesis that plasma P-tau217 concentration is increased by both β-amyloid plaques and tau tangles and is congruent with the hypothesis that P-tau is involved in β-amyloid-dependent formation of neocortical tau tangles.Item Tau PET correlates with different Alzheimer’s disease‐related features compared to CSF and plasma p‐tau biomarkers(EMBO Press, 2021) Ossenkoppele, Rik; Reimand, Juhan; Smith, Ruben; Leuzy, Antoine; Strandberg, Olof; Palmqvist, Sebastian; Stomrud, Erik; Zetterberg, Henrik; Alzheimer’s Disease Neuroimaging Initiative; Scheltens, Philip; Dage, Jeffrey L.; Bouwman, Femke; Blennow, Kaj; Mattsson-Carlgren, Niklas; Janelidze, Shorena; Hansson, Oskar; Neurology, School of MedicinePET, CSF and plasma biomarkers of tau pathology may be differentially associated with Alzheimer's disease (AD)-related demographic, cognitive, genetic and neuroimaging markers. We examined 771 participants with normal cognition, mild cognitive impairment or dementia from BioFINDER-2 (n = 400) and ADNI (n = 371). All had tau-PET ([18 F]RO948 in BioFINDER-2, [18 F]flortaucipir in ADNI) and CSF p-tau181 biomarkers available. Plasma p-tau181 and plasma/CSF p-tau217 were available in BioFINDER-2 only. Concordance between PET, CSF and plasma tau biomarkers ranged between 66 and 95%. Across the whole group, ridge regression models showed that increased CSF and plasma p-tau181 and p-tau217 levels were independently of tau PET associated with higher age, and APOEɛ4-carriership and Aβ-positivity, while increased tau-PET signal in the temporal cortex was associated with worse cognitive performance and reduced cortical thickness. We conclude that biofluid and neuroimaging markers of tau pathology convey partly independent information, with CSF and plasma p-tau181 and p-tau217 levels being more tightly linked with early markers of AD (especially Aβ-pathology), while tau-PET shows the strongest associations with cognitive and neurodegenerative markers of disease progression.Item The prevalence of tau‐PET positivity in aging and dementia(Wiley, 2025-01-09) Coomans, Emma M.; Groot, Colin; Rowe, Christopher C.; Dore, Vincent; Villemagne, Victor L.; van de Giessen, Elsmarieke; van der Flier, Wiesje M.; Pijnenburg, Yolande A. L.; Visser, Pieter Jelle; den Braber, Anouk; Pontecorvo, Michael; Shcherbinin, Sergey; Kennedy, Ian A.; Jagust, William J.; Baker, Suzanne L.; Harrison, Theresa M.; Gispert, Juan Domingo; Shekari, Mahnaz; Minguillon, Carolina; Smith, Ruben; Mattsson-Carlgren, Niklas; Palmqvist, Sebastian; Strandberg, Olof; Stomrud, Erik; Malpetti, Maura; O'Brien, John T.; Rowe, James B.; Jäger, Elena; Bischof, Gérard N.; Drzezga, Alexander; Garibotto, Valentina; Frisoni, Giovanni; Peretti, Débora Elisa; Schöll, Michael; Skoog, Ingmar; Kern, Silke; Sperling, Reisa A.; Johnson, Keith A.; Risacher, Shannon L.; Saykin, Andrew J.; Carrillo, Maria C.; Dickerson, Brad C.; Apostolova, Liana G.; Barthel, Henryk; Rullmann, Michael; Messerschmidt, Konstantin; Vandenberghe, Rik; Van Laere, Koen; Spruyt, Laure; Franzmeier, Nicolai; Brendel, Matthias; Gnörich, Johannes; Benzinger, Tammie L. S.; Lagarde, Julien; Sarazin, Marie; Bottlaender, Michel; Villeneuve, Sylvia; Poirier, Judes; Seo, Sang Won; Gu, Yuna; Kim, Jun Pyo; Mormino, Elizabeth; Young, Christina B.; Vossler, Hillary; Rosa-Neto, Pedro; Therriault, Joseph; Rahmouni, Nesrine; Coath, William; Cash, David M.; Schott, Jonathan M.; Rabinovici, Gil D.; La Joie, Renaud; Rosen, Howard J.; Johnson, Sterling C.; Christian, Bradley T.; Betthauser, Tobey J.; Hansson, Oskar; Ossenkoppele, Rik; Radiology and Imaging Sciences, School of MedicineBackground Tau‐PET imaging allows in‐vivo detection of neurofibrillary tangles. One tau‐PET tracer (i.e., [18F]flortaucipir) has received FDA‐approval for clinical use, and multiple other tau‐PET tracers have been implemented into clinical trials for participant selection and/or as a primary or secondary outcome measure. To optimize future use of tau‐PET, it is essential to understand how demographic, clinical and genetic factors affect tau‐PET‐positivity rates. Method This large‐scale multi‐center study includes 9713 participants from 35 cohorts worldwide who underwent tau‐PET with [18F]flortaucipir (n = 6420), [18F]RO948 (n = 1999), [18F]MK6240 (n = 878) or [18F]PI2620 (n = 416) (Table‐1). We analyzed individual‐level tau‐PET SUVR data using a cerebellar reference region that were processed either centrally (n = 3855) or by each cohort (n = 5858). We computed cohort‐specific SUVR thresholds based on the mean + 2 standard deviations in a temporal meta‐region of amyloid‐negative cognitively normal (CN) individuals aged >50. Logistic generalized estimating equations were used to estimate tau‐PET‐positivity probabilities, using an exchangeable correlation structure to account for within‐cohort correlations. Analyses were performed with (interactions between) age, amyloid‐status, and APOE‐e4 carriership as independent variables, stratified for syndrome diagnosis. Result The study included 5962 CN participants (7.5% tau‐PET‐positive), 1683 participants with mild cognitive impairment (MCI, 33.8% tau‐PET‐positive) and 2068 participants with a clinical diagnosis of dementia (62.1% tau‐PET‐positive) (Figure‐1). From age 60 to 80 years, the estimated prevalence of tau‐PET‐positivity increased from 1.2% [95% CI: 0.9%‐1.5%] to 3.7% [2.3%‐5.1%] among CN amyloid‐negative participants; and from 16.4% [10.8%‐22.1%] to 20.5% [18.8%‐22.2%] among CN amyloid‐positive participants. Among amyloid‐negative participants with MCI and dementia, from age 60 to 80 years, the estimated prevalence of tau‐PET‐positivity increased from 3.5% [1.6%‐5.3%] to 11.8% [7.1%‐16.5%] and from 12.6% [4.5%‐20.7%] to 15.9% [6.7%‐25.1%] respectively. In contrast, among amyloid‐positive participants with MCI and dementia, from age 60 to 80 years, the estimated prevalence of tau‐PET‐positivity decreased from 66.5% [57.0%‐76.0%] to 48.3% [42.9%‐53.8%] and from 92.3% [88.7%‐95.9%] to 73.4% [67.5%‐79.3%] respectively. APOE‐e4 status primarily modulated the association of age with tau‐PET‐positivity estimates among CN and MCI amyloid‐positive participants (Figure‐2). Conclusion This large‐scale multi‐cohort study provides robust prevalence estimates of tau‐PET‐positivity, which can aid the interpretation of tau‐PET in the clinic and inform clinical trial designs.