Comparing the predictive value of plasma p-tau217 and CSF biomarkers (p-tau181, Aβ42) using amyloid positron emission tomography in Alzheimer's continuum

INTRODUCTION: This study explores the diagnostic accuracy of different biomarkers for Alzheimer’s disease (AD) using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI).METHODS: A cross-sectional analysis was performed on individuals with mild cognitive impairment. Key biomarkers assessed included plasma p-tau217, CSF p-tau181, CSF Aβ42, and amyloid PET imaging, alongside clinical assessments using the Clinical Dementia Rating (CDR) and the Alzheimer's Disease Assessment Scale (ADAS).RESULTS: Plasma p-tau217 showed the strongest correlation with amyloid-β deposition and clinical scores (Adjusted R² = 0.53 for ADAS, 0.51 for CDR), outperforming CSF Aβ42 and CSF p-tau181.DISCUSSION: These results suggest that plasma p-tau217 may serve as a more accurate, cost-effective, and non-invasive alternative to CSF biomarkers and PET imaging. Its superior predictive power highlights its potential in routine clinical settings for early diagnosis and monitoring of AD progression, addressing key challenges in accessibility and patient compliance associated with current diagnostic methods.