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76/100

✓ Peer-reviewed alzhub usefulness score 76 out of 100. Getting a diagnosis

Topic: Amyloid, tau and blood-test diagnosis

The neuropathological confirmation of amyloid-β (Aβ) plaques and tau neurofibrillary tangles (NFT) remains the gold standard for a definitive diagnosis of Alzheimer's disease (AD). Nowadays, the in vivo diagnosis of AD is greatly aided by both cerebrospinal fluid (CSF) and positron emission tomography (PET) biomarkers. Although highly accurate, their broad implementation is restricted by high cost, limited accessibility and invasiveness. We recently developed a high-performance, ultrasensitive immunoassay for the quantification of tau phosphorylated at threonine-181 (p-tau181) in plasma, which identifies AD pathophysiology with high accuracy. However, it remains unclear whether plasma p-tau181, measured years before the death, can predict the eventual neuropathological confirmation of AD, and successfully discriminates AD from non-AD dementia pathologies. We studied a unique cohort of 115 individuals with longitudinal blood collections with clinical evaluation at 8, 4 and 2 years prior to neuropathological assessment at death. The results demonstrate that plasma p-tau181 associates better with AD neuropathology and Braak staging than a clinical diagnosis 8 years before post-mortem. Moreover, while all patients had a diagnosis of AD dementia during life, plasma p-tau181 proved to discriminate AD from non-AD pathologies with high accuracy (AUC = 97.4%, 95% CI = 94.1-100%) even 8 years before death. Additionally, the longitudinal trajectory of plasma p-tau181 was assessed in all patients. We found that the main increases in plasma p-tau181 occurred between 8 and 4 years prior to death in patients with AD neuropathology and later plateauing. In contrast, non-AD pathologies and controls exhibited minor, albeit significant, increases in p-tau181 up until death. Overall, our study demonstrates that plasma p-tau181 is highly predictive and specific of AD neuropathology years before post-mortem examination. These data add further support for the use of plasma p-tau181 to aid clinical management in primary care and recruitment for clinical trials.

Key findings

The results demonstrate that plasma p-tau181 associates better with AD neuropathology and Braak staging than a clinical diagnosis 8 years before post-mortem.
We found that the main increases in plasma p-tau181 occurred between 8 and 4 years prior to death in patients with AD neuropathology and later plateauing.
In contrast, non-AD pathologies and controls exhibited minor, albeit significant, increases in p-tau181 up until death.
Overall, our study demonstrates that plasma p-tau181 is highly predictive and specific of AD neuropathology years before post-mortem examination.

Why it matters

In 115 people who had blood drawn 8, 4 and 2 years before death and were then autopsied, plasma p-tau181 matched Alzheimer's brain pathology better than their clinical diagnosis did, and told Alzheimer's apart from other brain pathologies with high accuracy (AUC 97.4%, 95% CI 94.1–100%) even 8 years before death. It is a diagnostic finding from one cohort and does not show that measuring or lowering p-tau181 treats or prevents the disease.

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Study details

Study designlongitudinal study
Participants115
Effect sizeAUC = 97.4
Evidence strengthModerate

How this study scored 76/100

Published in a leading specialty journal, and it is a longitudinal study following the same people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 73 of the 96 points we could judge it on, which is 76 out of 100.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (Acta neuropathologica)
Journal's citation record	3 / 4	Acta Neuropathologica: journal h-index 287 (OpenAlex, 2026-10-29)
Study design	7 / 12	A longitudinal study following the same people over time
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	2 / 5	2020 — within 10 year(s) of the newest study here
Sample size	2 / 4	115 participants
Effect reported	3 / 3	Effect reported with a statistic (interval, p-value, ratio or similar)
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	6 / 7	Cited 352 times (OpenAlex, 2026-10-10)
Citations per year	4 / 5	44.0 citations a year over 8 year(s) since 2020
Impact for its field and year	5 / 6	Cited 34.3× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	4 / 6	Cited by 42 other studies in this library
Still being cited	3 / 4	Cited 137 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	— / 4	Senior author's record not available — left out of this score
Institution's track record	2 / 3	University College London: institution h-index 2,029 (OpenAlex)
Multi-centre collaboration	3 / 3	OpenAlex lists 16 institution(s) in 5 countries
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 32720099)
Free to read	2 / 2	Free to read
Points	73 / 96	Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 73 of the 96 points we could judge it on is 76 out of 100.
Total	76 / 100	—

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Read the original

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Cite this study APA, Vancouver, BibTeX · download .bib or .ris

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APA 7th

Lantero Rodriguez, J., Karikari, T. K., Suárez-Calvet, M., Troakes, C., King, A., Emersic, A., et al. (2020). Plasma p-tau181 accurately predicts Alzheimer's disease pathology at least 8 years prior to post-mortem and improves the clinical characterisation of cognitive decline. Acta neuropathologica. https://doi.org/10.1007/s00401-020-02195-x

Vancouver

Lantero Rodriguez J, Karikari TK, Suárez-Calvet M, Troakes C, King A, Emersic A, et al. Plasma p-tau181 accurately predicts Alzheimer's disease pathology at least 8 years prior to post-mortem and improves the clinical characterisation of cognitive decline. Acta neuropathologica. 2020. doi:10.1007/s00401-020-02195-x. PMID: 32720099.

BibTeX

@article{lanterorodriguez2020-32720099,
  author  = {Lantero Rodriguez, J. and Karikari, T. K. and Suárez-Calvet, M. and Troakes, C. and King, A. and Emersic, A. and Aarsland, D. and Hye, A. and others},
  title   = {{Plasma p-tau181 accurately predicts Alzheimer's disease pathology at least 8 years prior to post-mortem and improves the clinical characterisation of cognitive decline}},
  journal = {Acta neuropathologica},
  year    = {2020},
  doi     = {10.1007/s00401-020-02195-x},
  pmid    = {32720099},
  url     = {https://doi.org/10.1007/s00401-020-02195-x}
}

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