Tau PET imaging is a better predictor of Alzheimer’s Disease progression than amyloid beta PET imaging, according to Dr. Nicolai Franzmeier of Ludwig Maximilian University in Munich and colleagues of the international Alzheimer’s Disease Neuroimaging Initiative (ADNI), in a study published August 12, 2021, in Alzheimer’s Research and Therapy.

Beta-amyloid and tau are hallmark pathologies of Alzheimer’s disease and both are associated with the neurodegeneration, cognitive decline, and dementia that it brings. Tau pathology appears much closer to symptom onset than does Beta-amyloid; PET-based tau assessments show a strong association with cognitive decline; and tau spreads systematically (unlike Beta-amyloid) across the temporal lobe, association cortices, and eventually, primary sensorimotor cortices-a spatio-temporal progression closely associated with disease stage and cognitive performance write the authors. Thus, they reasoned, tau-PET “might facilitate patient-specific risk estimation in future cognitive decline in clinical settings, which would have implications for clinical decision making…or risk matching of subjects in clinical trials.”

The authors concluded that “tau-PET outperforms amyloid-PET in predicting cognitive decline and clinical AD progression, supporting the notion that tau-PET is—in contrast to amyloid-PET—of high clinical usefulness as a single meaningful predictor of future cognitive decline and clinical AD progression. Importantly, we found that regional tau staging allows more fine-grained risk estimation of future cognitive changes, which can be critical to stratify or match risk groups in clinical trials. From a clinical perspective, our findings suggest that in vivo tau-PET-based Braak-staging may be a valuable tool to identify subjects at imminent risk of cognitive decline.”

Sources:

Biel, D., Brendel, M., Rubinski, A. et al. Tau-PET and in vivo Braak-staging as prognostic markers of future cognitive decline in cognitively normal to demented individuals. Alz Res Therapy 13, 137 (2021). https://doi.org/10.1186/s13195-021-00880-x Available online August 12, 2021, at https://alzres.biomedcentral.com/articles/10.1186/s13195-021-00880-x Accessed August 23, 2021.

Morton, Will. Tau PET best for imaging Alzheimer’s disease progression. AuntMinnie.com Available online August 19, 2021, at https://www.auntminnie.com/index.aspx?sec=sup&sub=mol&pag=dis&ItemID=133256 Accessed August 23, 2021.