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Beyond binary classification: Comparing three region-based multi-phase Aβ staging systems
Cui L, Zhang Z, Huang CC, Yuan CY, Tu YY, Wang M, Guan YH, Li YH et al.. Alzheimer's & dementia : the journal of the Alzheimer's Association, 2025-05-01
Topic: Amyloid, tau and blood-test diagnosis
Introduction This study aims to establish a multi-phase visual staging system based on amyloid-beta (Aβ) deposition to more precisely assess the stages of Aβ accumulation in Alzheimer's disease (AD), and to validate the cognitive function, neurodegeneration, and blood biomarker characteristics at different stages. Methods A total of 1002 participants from the Chinese Preclinical Alzheimer's Disease Study (C-PAS) cohort were included. Aβ deposition was assessed using positron emission tomography (PET) imaging, and three multi-phase Aβ deposition grading systems were established. Participants underwent neuropsychological testing, peripheral blood biomarker collection, and multimodal neuroimaging data acquisition. Results Cognitive function, peripheral blood biomarkers, default mode network (DMN) function, and hippocampal volumes showed stage-dependent changes across different Aβ deposition stages. Different grading systems revealed varying clinical manifestations and biomarker sensitivity. Discussion Region-based multi-phase Aβ deposition systems demonstrate practical utility in detecting early pathological changes, understanding disease progression, and informing early diagnosis and intervention strategies for AD. Highlights Developed and validated visual multi-phase Aβ deposition staging systems for AD progression. Revealed stage-specific cognitive, neurodegenerative, and biomarker characteristics in AD. Demonstrated the sensitivity of visual methods to detect early, regional Aβ deposition. Highlighted differential strengths of Villeneuve, Grothe, and Mattsson staging systems. Proposed multi-phase systems as tools for personalized AD diagnosis and intervention strategies.
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APA 7th
Cui, L., Zhang, Z., Huang, C. C., Yuan, C. Y., Tu, Y. Y., Wang, M., et al. (2025). Beyond binary classification: Comparing three region-based multi-phase Aβ staging systems. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1002/alz.70253
Vancouver
Cui L, Zhang Z, Huang CC, Yuan CY, Tu YY, Wang M, et al. Beyond binary classification: Comparing three region-based multi-phase Aβ staging systems. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2025. doi:10.1002/alz.70253. PMID: 40390199.
BibTeX
@article{cui2025-40390199,
author = {Cui, L. and Zhang, Z. and Huang, C. C. and Yuan, C. Y. and Tu, Y. Y. and Wang, M. and Guan, Y. H. and Li, Y. H. and others},
title = {{Beyond binary classification: Comparing three region-based multi-phase Aβ staging systems}},
journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
year = {2025},
doi = {10.1002/alz.70253},
pmid = {40390199},
url = {https://doi.org/10.1002/alz.70253}
}
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Key findings
- Results Cognitive function, peripheral blood biomarkers, default mode network (DMN) function, and hippocampal volumes showed stage-dependent changes across different Aβ deposition stages.
- Different grading systems revealed varying clinical manifestations and biomarker sensitivity.
- Revealed stage-specific cognitive, neurodegenerative, and biomarker characteristics in AD.
- Demonstrated the sensitivity of visual methods to detect early, regional Aβ deposition.
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Study details
- Participants1,002
- Evidence strengthModerate
How this study scored 62/100
Published in a leading specialty journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 36 of the 58 points we could judge it on, which is 62 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & dementia : the journal of the Alzheimer's Association) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,002 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40390199) |
| Free to read | 2 / 2 | Free to read |
| Points | 36 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 36 of the 58 points we could judge it on is 62 out of 100. |
| Total | 62 / 100 | — |
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