We examined baseline and longitudinal associations between plasma neurofilament light (NfL) and total tau (t-tau), and the clinical presentation of Alzheimer's disease (AD). A total of 579 participants (238, normal cognition [NC]; 185, mild cognitive impairment [MCI]; 156, AD dementia) had baseline blood draws; 82% had follow-up evaluations. Plasma samples were analyzed for NfL and t-tau using Simoa technology. Baseline plasma NfL was higher in AD dementia than MCI (standardized mean difference = 0.55, 95% CI: 0.37-0.73) and NC (standardized mean difference = 0.68, 95% CI: 0.49-0.88), corresponded to Clinical Dementia Rating scores (OR = 1.94, 95% CI: 1.35-2.79]), and correlated with all neuropsychological tests (r's = 0.13-0.42). Longitudinally, NfL did not predict diagnostic conversion but predicted decline on 3/10 neuropsychological tests. Baseline plasma t-tau was higher in AD dementia than NC with a small effect (standardized mean difference = 0.33, 95% CI: 0.10-0.57) but not MCI. t-tau did not statistically significant predict any longitudinal outcomes. Plasma NfL may be useful for the detection of AD dementia and monitoring of disease progression. In contrast, there was minimal evidence in support of plasma t-tau.

中文翻译：

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用于临床检测和监测阿尔茨海默病的血浆神经丝光和总 Tau 的纵向检查

我们检查了血浆神经丝光 (NfL) 和总 tau (t-tau) 之间的基线和纵向关联，以及阿尔茨海默病 (AD) 的临床表现。共有 579 名参与者（238 名，认知正常 [NC]；185 名，轻度认知障碍 [MCI]；156 名，AD 痴呆）进行了基线抽血；82% 进行了后续评估。使用 Simoa 技术分析血浆样品的 NfL 和 t-tau。AD 痴呆患者的基线血浆 NfL 高于 MCI（标准化均数差 = 0.55，95% CI：0.37-0.73）和 NC（标准化均数差 = 0.68，95% CI：0.49-0.88），对应于临床痴呆评分评分（ OR = 1.94, 95% CI: 1.35-2.79]），并与所有神经心理学测试相关（r = 0.13-0.42）。纵向上，NfL 没有预测诊断转换，但预测了 3/10 神经心理学测试的下降。AD 痴呆患者的基线血浆 t-tau 高于 NC，但影响较小（标准化均数差 = 0.33，95% CI：0.10-0.57），但 MCI 没有。t-tau 没有统计学上显着的预测任何纵向结果。血浆 NfL 可用于检测 AD 痴呆和监测疾病进展。相比之下，支持血浆 t-tau 的证据很少。