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Plasma proteins predict conversion to dementia from prodromal disease

Identifieur interne : 001406 ( Pmc/Checkpoint ); précédent : 001405; suivant : 001407

Plasma proteins predict conversion to dementia from prodromal disease

Auteurs : Abdul Hye [Royaume-Uni] ; Joanna Riddoch-Contreras [Royaume-Uni] ; Alison L. Baird [Royaume-Uni] ; Nicholas J. Ashton [Royaume-Uni] ; Chantal Bazenet [Royaume-Uni] ; Rufina Leung [Royaume-Uni] ; Eric Westman [Royaume-Uni, Suède] ; Andrew Simmons [Royaume-Uni] ; Richard Dobson [Royaume-Uni] ; Martina Sattlecker [Royaume-Uni] ; Michelle Lupton [Royaume-Uni, Australie] ; Katie Lunnon [Royaume-Uni] ; Aoife Keohane [Royaume-Uni] ; Malcolm Ward [Royaume-Uni] ; Ian Pike [Royaume-Uni] ; Hans Dieter Zucht [Royaume-Uni] ; Danielle Pepin [États-Unis] ; Wei Zheng [États-Unis] ; Alan Tunnicliffe [États-Unis] ; Jill Richardson [Royaume-Uni] ; Serge Gauthier [Canada] ; Hilkka Soininen [Finlande] ; Iwona Kłoszewska [Pologne] ; Patrizia Mecocci [Italie] ; Magda Tsolaki [Grèce] ; Bruno Vellas [France] ; Simon Lovestone [Royaume-Uni]

Source :

RBID : PMC:4240530

Abstract

Background

The study aimed to validate previously discovered plasma biomarkers associated with AD, using a design based on imaging measures as surrogate for disease severity and assess their prognostic value in predicting conversion to dementia.

Methods

Three multicenter cohorts of cognitively healthy elderly, mild cognitive impairment (MCI), and AD participants with standardized clinical assessments and structural neuroimaging measures were used. Twenty-six candidate proteins were quantified in 1148 subjects using multiplex (xMAP) assays.

Results

Sixteen proteins correlated with disease severity and cognitive decline. Strongest associations were in the MCI group with a panel of 10 proteins predicting progression to AD (accuracy 87%, sensitivity 85%, and specificity 88%).

Conclusions

We have identified 10 plasma proteins strongly associated with disease severity and disease progression. Such markers may be useful for patient selection for clinical trials and assessment of patients with predisease subjective memory complaints.


Url:
DOI: 10.1016/j.jalz.2014.05.1749
PubMed: 25012867
PubMed Central: 4240530


Affiliations:


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Le document en format XML

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<name sortKey="Soininen, Hilkka" sort="Soininen, Hilkka" uniqKey="Soininen H" first="Hilkka" last="Soininen">Hilkka Soininen</name>
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<name sortKey="Kloszewska, Iwona" sort="Kloszewska, Iwona" uniqKey="Kloszewska I" first="Iwona" last="Kłoszewska">Iwona Kłoszewska</name>
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<name sortKey="Mecocci, Patrizia" sort="Mecocci, Patrizia" uniqKey="Mecocci P" first="Patrizia" last="Mecocci">Patrizia Mecocci</name>
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<name sortKey="Tsolaki, Magda" sort="Tsolaki, Magda" uniqKey="Tsolaki M" first="Magda" last="Tsolaki">Magda Tsolaki</name>
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<title xml:lang="en" level="a" type="main">Plasma proteins predict conversion to dementia from prodromal disease</title>
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<name sortKey="Riddoch Contreras, Joanna" sort="Riddoch Contreras, Joanna" uniqKey="Riddoch Contreras J" first="Joanna" last="Riddoch-Contreras">Joanna Riddoch-Contreras</name>
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<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
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<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Ashton, Nicholas J" sort="Ashton, Nicholas J" uniqKey="Ashton N" first="Nicholas J." last="Ashton">Nicholas J. Ashton</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London</wicri:regionArea>
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<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Bazenet, Chantal" sort="Bazenet, Chantal" uniqKey="Bazenet C" first="Chantal" last="Bazenet">Chantal Bazenet</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Leung, Rufina" sort="Leung, Rufina" uniqKey="Leung R" first="Rufina" last="Leung">Rufina Leung</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Westman, Eric" sort="Westman, Eric" uniqKey="Westman E" first="Eric" last="Westman">Eric Westman</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<nlm:aff id="aff2">Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea>Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm</wicri:regionArea>
<placeName>
<settlement type="city">Stockholm</settlement>
<region nuts="2">Svealand</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Simmons, Andrew" sort="Simmons, Andrew" uniqKey="Simmons A" first="Andrew" last="Simmons">Andrew Simmons</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Dobson, Richard" sort="Dobson, Richard" uniqKey="Dobson R" first="Richard" last="Dobson">Richard Dobson</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Sattlecker, Martina" sort="Sattlecker, Martina" uniqKey="Sattlecker M" first="Martina" last="Sattlecker">Martina Sattlecker</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Lupton, Michelle" sort="Lupton, Michelle" uniqKey="Lupton M" first="Michelle" last="Lupton">Michelle Lupton</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
<affiliation wicri:level="1">
<nlm:aff id="aff3">Department of Neuroimaging Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Neuroimaging Genetics, QIMR Berghofer Medical Research Institute, Brisbane</wicri:regionArea>
<wicri:noRegion>Brisbane</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Lunnon, Katie" sort="Lunnon, Katie" uniqKey="Lunnon K" first="Katie" last="Lunnon">Katie Lunnon</name>
<affiliation wicri:level="1">
<nlm:aff id="aff4">University of Exeter Medical School, Exeter University, Exeter, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>University of Exeter Medical School, Exeter University, Exeter</wicri:regionArea>
<wicri:noRegion>Exeter</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Keohane, Aoife" sort="Keohane, Aoife" uniqKey="Keohane A" first="Aoife" last="Keohane">Aoife Keohane</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Ward, Malcolm" sort="Ward, Malcolm" uniqKey="Ward M" first="Malcolm" last="Ward">Malcolm Ward</name>
<affiliation wicri:level="1">
<nlm:aff id="aff5">Proteome Sciences plc, Research & Development, Proteome Sciences plc, Cobham, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Proteome Sciences plc, Research & Development, Proteome Sciences plc, Cobham</wicri:regionArea>
<wicri:noRegion>Cobham</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Pike, Ian" sort="Pike, Ian" uniqKey="Pike I" first="Ian" last="Pike">Ian Pike</name>
<affiliation wicri:level="1">
<nlm:aff id="aff5">Proteome Sciences plc, Research & Development, Proteome Sciences plc, Cobham, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Proteome Sciences plc, Research & Development, Proteome Sciences plc, Cobham</wicri:regionArea>
<wicri:noRegion>Cobham</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Zucht, Hans Dieter" sort="Zucht, Hans Dieter" uniqKey="Zucht H" first="Hans Dieter" last="Zucht">Hans Dieter Zucht</name>
<affiliation wicri:level="1">
<nlm:aff id="aff5">Proteome Sciences plc, Research & Development, Proteome Sciences plc, Cobham, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Proteome Sciences plc, Research & Development, Proteome Sciences plc, Cobham</wicri:regionArea>
<wicri:noRegion>Cobham</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Pepin, Danielle" sort="Pepin, Danielle" uniqKey="Pepin D" first="Danielle" last="Pepin">Danielle Pepin</name>
<affiliation wicri:level="2">
<nlm:aff id="aff6">Protein Analysis and Detection, EMD Millipore Corporation, St. Charles, MO, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Protein Analysis and Detection, EMD Millipore Corporation, St. Charles, MO</wicri:regionArea>
<placeName>
<region type="state">Missouri (État)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Zheng, Wei" sort="Zheng, Wei" uniqKey="Zheng W" first="Wei" last="Zheng">Wei Zheng</name>
<affiliation wicri:level="2">
<nlm:aff id="aff6">Protein Analysis and Detection, EMD Millipore Corporation, St. Charles, MO, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Protein Analysis and Detection, EMD Millipore Corporation, St. Charles, MO</wicri:regionArea>
<placeName>
<region type="state">Missouri (État)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Tunnicliffe, Alan" sort="Tunnicliffe, Alan" uniqKey="Tunnicliffe A" first="Alan" last="Tunnicliffe">Alan Tunnicliffe</name>
<affiliation wicri:level="2">
<nlm:aff id="aff6">Protein Analysis and Detection, EMD Millipore Corporation, St. Charles, MO, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Protein Analysis and Detection, EMD Millipore Corporation, St. Charles, MO</wicri:regionArea>
<placeName>
<region type="state">Missouri (État)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Richardson, Jill" sort="Richardson, Jill" uniqKey="Richardson J" first="Jill" last="Richardson">Jill Richardson</name>
<affiliation wicri:level="1">
<nlm:aff id="aff7">Neurosciences Therapy Area Unit, GlaxoSmithKline Medicines Research Centre, Hertfordshire, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Neurosciences Therapy Area Unit, GlaxoSmithKline Medicines Research Centre, Hertfordshire</wicri:regionArea>
<wicri:noRegion>Hertfordshire</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Gauthier, Serge" sort="Gauthier, Serge" uniqKey="Gauthier S" first="Serge" last="Gauthier">Serge Gauthier</name>
<affiliation wicri:level="1">
<nlm:aff id="aff8">Departments of Neurology & Neurosurgery, Psychiatry, Medicine, McGill Centre for Studies in Aging, Verdun, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Departments of Neurology & Neurosurgery, Psychiatry, Medicine, McGill Centre for Studies in Aging, Verdun</wicri:regionArea>
<wicri:noRegion>Verdun</wicri:noRegion>
</affiliation>
<affiliation>
<nlm:aff id="aff9">on behalf of GenADA consortium</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Soininen, Hilkka" sort="Soininen, Hilkka" uniqKey="Soininen H" first="Hilkka" last="Soininen">Hilkka Soininen</name>
<affiliation wicri:level="1">
<nlm:aff id="aff10">Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland</nlm:aff>
<country xml:lang="fr">Finlande</country>
<wicri:regionArea>Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio</wicri:regionArea>
<wicri:noRegion>Kuopio</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Kloszewska, Iwona" sort="Kloszewska, Iwona" uniqKey="Kloszewska I" first="Iwona" last="Kłoszewska">Iwona Kłoszewska</name>
<affiliation wicri:level="1">
<nlm:aff id="aff11">Department of Old Age Psychiatry and Psychotic disorders, Medical University of Lodz, Lodz, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Old Age Psychiatry and Psychotic disorders, Medical University of Lodz, Lodz</wicri:regionArea>
<wicri:noRegion>Lodz</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Mecocci, Patrizia" sort="Mecocci, Patrizia" uniqKey="Mecocci P" first="Patrizia" last="Mecocci">Patrizia Mecocci</name>
<affiliation wicri:level="1">
<nlm:aff id="aff12">Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Institute of Gerontology and Geriatrics, University of Perugia, Perugia</wicri:regionArea>
<wicri:noRegion>Perugia</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Tsolaki, Magda" sort="Tsolaki, Magda" uniqKey="Tsolaki M" first="Magda" last="Tsolaki">Magda Tsolaki</name>
<affiliation wicri:level="1">
<nlm:aff id="aff13">3rd Department of Neurology, Aristotle University, Thessaloniki, Greece</nlm:aff>
<country xml:lang="fr">Grèce</country>
<wicri:regionArea>3rd Department of Neurology, Aristotle University, Thessaloniki</wicri:regionArea>
<wicri:noRegion>Thessaloniki</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Vellas, Bruno" sort="Vellas, Bruno" uniqKey="Vellas B" first="Bruno" last="Vellas">Bruno Vellas</name>
<affiliation wicri:level="3">
<nlm:aff id="aff14">Department of Internal Medicine and Geriatric Medicine, INSERM U 558, University of Toulouse, Toulouse, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Internal Medicine and Geriatric Medicine, INSERM U 558, University of Toulouse, Toulouse</wicri:regionArea>
<placeName>
<region type="region">Occitanie (région administrative)</region>
<region type="old region">Midi-Pyrénées</region>
<settlement type="city">Toulouse</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Lovestone, Simon" sort="Lovestone, Simon" uniqKey="Lovestone S" first="Simon" last="Lovestone">Simon Lovestone</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
<affiliation wicri:level="4">
<nlm:aff id="aff15">Department of Psychiatry, University of Oxford, Oxford, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Psychiatry, University of Oxford, Oxford</wicri:regionArea>
<placeName>
<settlement type="city">Oxford</settlement>
<region type="country">Angleterre</region>
<region type="comté" nuts="2">Oxfordshire</region>
<settlement type="city">Oxford</settlement>
</placeName>
<orgName type="university">Université d'Oxford</orgName>
</affiliation>
<affiliation>
<nlm:aff id="aff16">on behalf of AddNeuroMed consortium</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Alzheimer's & Dementia</title>
<idno type="ISSN">1552-5260</idno>
<idno type="eISSN">1552-5279</idno>
<imprint>
<date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Background</title>
<p>The study aimed to validate previously discovered plasma biomarkers associated with AD, using a design based on imaging measures as surrogate for disease severity and assess their prognostic value in predicting conversion to dementia.</p>
</sec>
<sec>
<title>Methods</title>
<p>Three multicenter cohorts of cognitively healthy elderly, mild cognitive impairment (MCI), and AD participants with standardized clinical assessments and structural neuroimaging measures were used. Twenty-six candidate proteins were quantified in 1148 subjects using multiplex (xMAP) assays.</p>
</sec>
<sec>
<title>Results</title>
<p>Sixteen proteins correlated with disease severity and cognitive decline. Strongest associations were in the MCI group with a panel of 10 proteins predicting progression to AD (accuracy 87%, sensitivity 85%, and specificity 88%).</p>
</sec>
<sec>
<title>Conclusions</title>
<p>We have identified 10 plasma proteins strongly associated with disease severity and disease progression. Such markers may be useful for patient selection for clinical trials and assessment of patients with predisease subjective memory complaints.</p>
</sec>
</div>
</front>
<back>
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<author>
<name sortKey="Glodzik, L" uniqKey="Glodzik L">L. Glodzik</name>
</author>
<author>
<name sortKey="Mosconi, L" uniqKey="Mosconi L">L. Mosconi</name>
</author>
<author>
<name sortKey="Switalski, R" uniqKey="Switalski R">R. Switalski</name>
</author>
<author>
<name sortKey="De Santi, S" uniqKey="De Santi S">S. De Santi</name>
</author>
<author>
<name sortKey="Pirraglia, E" uniqKey="Pirraglia E">E. Pirraglia</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Alzheimers Dement</journal-id>
<journal-id journal-id-type="iso-abbrev">Alzheimers Dement</journal-id>
<journal-title-group>
<journal-title>Alzheimer's & Dementia</journal-title>
</journal-title-group>
<issn pub-type="ppub">1552-5260</issn>
<issn pub-type="epub">1552-5279</issn>
<publisher>
<publisher-name>Elsevier, Inc</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">25012867</article-id>
<article-id pub-id-type="pmc">4240530</article-id>
<article-id pub-id-type="publisher-id">S1552-5260(14)02454-6</article-id>
<article-id pub-id-type="doi">10.1016/j.jalz.2014.05.1749</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Featured Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Plasma proteins predict conversion to dementia from prodromal disease</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Hye</surname>
<given-names>Abdul</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="fn1" ref-type="fn">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Riddoch-Contreras</surname>
<given-names>Joanna</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="fn1" ref-type="fn">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Baird</surname>
<given-names>Alison L.</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ashton</surname>
<given-names>Nicholas J.</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bazenet</surname>
<given-names>Chantal</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Leung</surname>
<given-names>Rufina</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Westman</surname>
<given-names>Eric</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="aff2" ref-type="aff">b</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Simmons</surname>
<given-names>Andrew</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dobson</surname>
<given-names>Richard</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sattlecker</surname>
<given-names>Martina</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lupton</surname>
<given-names>Michelle</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="aff3" ref-type="aff">c</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lunnon</surname>
<given-names>Katie</given-names>
</name>
<xref rid="aff4" ref-type="aff">d</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Keohane</surname>
<given-names>Aoife</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ward</surname>
<given-names>Malcolm</given-names>
</name>
<xref rid="aff5" ref-type="aff">e</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pike</surname>
<given-names>Ian</given-names>
</name>
<xref rid="aff5" ref-type="aff">e</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zucht</surname>
<given-names>Hans Dieter</given-names>
</name>
<xref rid="aff5" ref-type="aff">e</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pepin</surname>
<given-names>Danielle</given-names>
</name>
<xref rid="aff6" ref-type="aff">f</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zheng</surname>
<given-names>Wei</given-names>
</name>
<xref rid="aff6" ref-type="aff">f</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tunnicliffe</surname>
<given-names>Alan</given-names>
</name>
<xref rid="aff6" ref-type="aff">f</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Richardson</surname>
<given-names>Jill</given-names>
</name>
<xref rid="aff7" ref-type="aff">g</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Gauthier</surname>
<given-names>Serge</given-names>
</name>
<xref rid="aff8" ref-type="aff">h</xref>
<xref rid="aff9" ref-type="aff">i</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Soininen</surname>
<given-names>Hilkka</given-names>
</name>
<xref rid="aff10" ref-type="aff">j</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kłoszewska</surname>
<given-names>Iwona</given-names>
</name>
<xref rid="aff11" ref-type="aff">k</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mecocci</surname>
<given-names>Patrizia</given-names>
</name>
<xref rid="aff12" ref-type="aff">l</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tsolaki</surname>
<given-names>Magda</given-names>
</name>
<xref rid="aff13" ref-type="aff">m</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Vellas</surname>
<given-names>Bruno</given-names>
</name>
<xref rid="aff14" ref-type="aff">n</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lovestone</surname>
<given-names>Simon</given-names>
</name>
<email>simon.lovestone@psych.ox.ac.uk</email>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="aff15" ref-type="aff">o</xref>
<xref rid="aff16" ref-type="aff">p</xref>
<xref rid="cor1" ref-type="corresp"></xref>
</contrib>
</contrib-group>
<aff id="aff1">
<label>a</label>
Institute of Psychiatry, Department of Old Age Psychiatry, King's College London, London, UK</aff>
<aff id="aff2">
<label>b</label>
Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden</aff>
<aff id="aff3">
<label>c</label>
Department of Neuroimaging Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia</aff>
<aff id="aff4">
<label>d</label>
University of Exeter Medical School, Exeter University, Exeter, UK</aff>
<aff id="aff5">
<label>e</label>
Proteome Sciences plc, Research & Development, Proteome Sciences plc, Cobham, UK</aff>
<aff id="aff6">
<label>f</label>
Protein Analysis and Detection, EMD Millipore Corporation, St. Charles, MO, USA</aff>
<aff id="aff7">
<label>g</label>
Neurosciences Therapy Area Unit, GlaxoSmithKline Medicines Research Centre, Hertfordshire, UK</aff>
<aff id="aff8">
<label>h</label>
Departments of Neurology & Neurosurgery, Psychiatry, Medicine, McGill Centre for Studies in Aging, Verdun, Canada</aff>
<aff id="aff9">
<label>i</label>
on behalf of GenADA consortium</aff>
<aff id="aff10">
<label>j</label>
Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland</aff>
<aff id="aff11">
<label>k</label>
Department of Old Age Psychiatry and Psychotic disorders, Medical University of Lodz, Lodz, Poland</aff>
<aff id="aff12">
<label>l</label>
Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy</aff>
<aff id="aff13">
<label>m</label>
3rd Department of Neurology, Aristotle University, Thessaloniki, Greece</aff>
<aff id="aff14">
<label>n</label>
Department of Internal Medicine and Geriatric Medicine, INSERM U 558, University of Toulouse, Toulouse, France</aff>
<aff id="aff15">
<label>o</label>
Department of Psychiatry, University of Oxford, Oxford, UK</aff>
<aff id="aff16">
<label>p</label>
on behalf of AddNeuroMed consortium</aff>
<author-notes>
<corresp id="cor1">
<label></label>
Corresponding author. Tel.: +44-(0)1865-223910. Fax: +44 (0)1865 251076
<email>simon.lovestone@psych.ox.ac.uk</email>
</corresp>
<fn id="fn1">
<label>1</label>
<p>These authors contributed equally.</p>
</fn>
</author-notes>
<pub-date pub-type="pmc-release">
<day>1</day>
<month>11</month>
<year>2014</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub">
<month>11</month>
<year>2014</year>
</pub-date>
<volume>10</volume>
<issue>6</issue>
<fpage>799</fpage>
<lpage>807.e2</lpage>
<permissions>
<copyright-statement>© 2014 The Authors</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract>
<sec>
<title>Background</title>
<p>The study aimed to validate previously discovered plasma biomarkers associated with AD, using a design based on imaging measures as surrogate for disease severity and assess their prognostic value in predicting conversion to dementia.</p>
</sec>
<sec>
<title>Methods</title>
<p>Three multicenter cohorts of cognitively healthy elderly, mild cognitive impairment (MCI), and AD participants with standardized clinical assessments and structural neuroimaging measures were used. Twenty-six candidate proteins were quantified in 1148 subjects using multiplex (xMAP) assays.</p>
</sec>
<sec>
<title>Results</title>
<p>Sixteen proteins correlated with disease severity and cognitive decline. Strongest associations were in the MCI group with a panel of 10 proteins predicting progression to AD (accuracy 87%, sensitivity 85%, and specificity 88%).</p>
</sec>
<sec>
<title>Conclusions</title>
<p>We have identified 10 plasma proteins strongly associated with disease severity and disease progression. Such markers may be useful for patient selection for clinical trials and assessment of patients with predisease subjective memory complaints.</p>
</sec>
</abstract>
<kwd-group>
<title>Keywords</title>
<kwd>Plasma</kwd>
<kwd>Mild cognitive impairment</kwd>
<kwd>Pathology</kwd>
<kwd>Alzheimer's disease</kwd>
<kwd>Biomarker</kwd>
<kwd>Prediction and magnetic resonance imaging</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<fig id="fig1">
<label>Fig. 1</label>
<caption>
<p>Feature selection workflow used to select the best attributes for mild cognitive impairment converter (MCI
<sub>c</sub>
) classification.</p>
</caption>
<graphic xlink:href="gr1"></graphic>
</fig>
<fig id="fig2">
<label>Fig. 2</label>
<caption>
<p>Receiver operating characteristic (ROC) curves obtained for the test set for (A) three models (proteins only, proteins + apolipoprotein E [APOE], and APOE only) from the full mild cognitive impairment, converter and nonconverter (MCI
<sub>c</sub>
and MCI
<sub>nc</sub>
) data sets and (B) for the test set for three models (proteins only, proteins + APOE + magnetic resonance imaging [MRI], and MRI only) in the subset with protein plus MRI imaging data.</p>
</caption>
<graphic xlink:href="gr2"></graphic>
</fig>
<table-wrap id="tbl1" position="float">
<label>Table 1</label>
<caption>
<p>Subject demographics</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th rowspan="2"></th>
<th rowspan="2">Control</th>
<th colspan="2">MCI
<hr></hr>
</th>
<th rowspan="2">AD</th>
<th rowspan="2">Significance</th>
</tr>
<tr>
<th>MCI
<sub>nc</sub>
</th>
<th>MCI
<sub>c</sub>
</th>
</tr>
</thead>
<tbody>
<tr>
<td>N</td>
<td>452</td>
<td>169</td>
<td>51</td>
<td>476</td>
<td></td>
</tr>
<tr>
<td>Age (yrs)</td>
<td align="char">75.6 (±6.3, 53–93)</td>
<td align="char">76.3 (±5.7, 65–90)</td>
<td align="char">76.2 (±6.9, 56–89)</td>
<td align="char">77.0 (±6.4, 58-96)</td>
<td>
<italic>P</italic>
 = .012
<xref rid="tbl1fndagger" ref-type="table-fn"></xref>
</td>
</tr>
<tr>
<td>Sex (%, female)</td>
<td>55.6%</td>
<td>50.1%</td>
<td>49.1%</td>
<td>49.4%</td>
<td>
<italic>P</italic>
 = .277</td>
</tr>
<tr>
<td>APOE genotype (%, e4+)</td>
<td>28%</td>
<td>35%</td>
<td>55%</td>
<td>59%</td>
<td>
<italic>P</italic>
 < .001
<xref rid="tbl1fndagger" ref-type="table-fn"></xref>
</td>
</tr>
<tr>
<td>MMSE</td>
<td align="char">29.0 (±1.2, 22–30)</td>
<td align="char">26.9 (±2.9, 0–30)</td>
<td align="char">26.3 (±2.1, 18-30)</td>
<td align="char">20.8 (±5.4, 0–30)</td>
<td>
<italic>P</italic>
 < .001
<xref rid="tbl1fnlowast" ref-type="table-fn"></xref>
</td>
</tr>
<tr>
<td>CDR (sum of boxes)</td>
<td align="char">0.18 (±0.4, 0–3)</td>
<td align="char">1.82 (±0.9, 0–4.5)</td>
<td align="char">2·41 (±0.9, 0.5–5)</td>
<td align="char">4.04 (±3.2, 0–20)</td>
<td>
<italic>P</italic>
 < .001
<xref rid="tbl1fnlowast" ref-type="table-fn"></xref>
</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Abbreviations: MCI, mild cognitive impairment; MCI
<sub>nc</sub>
, mild cognitive impairment non-converter; MCI
<sub>c</sub>
, mild cognitive impairment converter; AD, Alzheimer's disease; APOE, apolipoprotein E; MMSE, Mini-Mental State Examination; CDR, clinical dementia rating; mean (±standard deviation, range), analysis of variance was performed and if significant a Tukey's post hoc comparison was carried out.</p>
</fn>
</table-wrap-foot>
<table-wrap-foot>
<fn id="tbl1fnlowast">
<label></label>
<p>Significance across all three groups.</p>
</fn>
</table-wrap-foot>
<table-wrap-foot>
<fn id="tbl1fndagger">
<label></label>
<p>Control compared with AD.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tbl2" position="float">
<label>Table 2</label>
<caption>
<p>Proteins identified as significantly associated with structural brain MRI measures in the (A) MCI group and (B) AD group</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th colspan="5">(A) MCI group
<hr></hr>
</th>
</tr>
<tr>
<th>MRI brain region</th>
<th>Protein</th>
<th>Correlation coefficient
<xref rid="tbl2fnlowast" ref-type="table-fn"></xref>
</th>
<th>Significance (two-tailed)</th>
<th>df</th>
</tr>
</thead>
<tbody>
<tr>
<td rowspan="2">Ventricular volume</td>
<td>Clusterin</td>
<td align="char">0.23</td>
<td align="char">0.01</td>
<td align="char">115</td>
</tr>
<tr>
<td>RANTES</td>
<td align="char">−0.19</td>
<td align="char">0.03</td>
<td align="char">116</td>
</tr>
<tr>
<td rowspan="2">Mean hippocampal volume</td>
<td>Clusterin</td>
<td align="char">−0.38</td>
<td align="char">0.00</td>
<td align="char">115</td>
</tr>
<tr>
<td>NSE</td>
<td align="char">0.22</td>
<td align="char">0.02</td>
<td align="char">116</td>
</tr>
<tr>
<td>Right Entorhinal thickness</td>
<td>Clusterin</td>
<td align="char">−0.22</td>
<td align="char">0.02</td>
<td align="char">115</td>
</tr>
<tr>
<td>Left Entorhinal thickness</td>
<td>Prealbumin</td>
<td align="char">−0.20</td>
<td align="char">0.04</td>
<td align="char">109</td>
</tr>
<tr>
<td>Mean Entorhinal volume</td>
<td>n/a</td>
<td>n/a</td>
<td>n/a</td>
<td>n/a</td>
</tr>
<tr>
<td>Mean Entorhinal Thickness</td>
<td>n/a</td>
<td>n/a</td>
<td>n/a</td>
<td>n/a</td>
</tr>
<tr>
<td rowspan="3">Whole Brain Volume</td>
<td>Clusterin</td>
<td align="char">−0.25</td>
<td align="char">0.01</td>
<td align="char">118</td>
</tr>
<tr>
<td>NSE</td>
<td align="char">0.21</td>
<td align="char">0.02</td>
<td align="char">119</td>
</tr>
<tr>
<td>RANTES</td>
<td align="char">0.19</td>
<td align="char">0.04</td>
<td align="char">119</td>
</tr>
</tbody>
</table>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th colspan="5">(B) AD group
<hr></hr>
</th>
</tr>
<tr>
<th>MRI brain region</th>
<th>Protein</th>
<th>Correlation coefficient
<xref rid="tbl2fnlowast" ref-type="table-fn"></xref>
</th>
<th>Significance (2-tailed)</th>
<th>df</th>
</tr>
</thead>
<tbody>
<tr>
<td rowspan="2">Ventricular volume</td>
<td>A1AT</td>
<td align="char">0.24</td>
<td align="char">0.01</td>
<td align="char">119</td>
</tr>
<tr>
<td>NSE</td>
<td align="char">0.16</td>
<td align="char">0.03</td>
<td align="char">169</td>
</tr>
<tr>
<td rowspan="4">Mean hippocampal volume</td>
<td>BDNF</td>
<td align="char">−0.21</td>
<td align="char">0.02</td>
<td align="char">123</td>
</tr>
<tr>
<td>ApoC3</td>
<td align="char">−0.18</td>
<td align="char">0.02</td>
<td align="char">168</td>
</tr>
<tr>
<td>ApoA1</td>
<td align="char">−0.15</td>
<td align="char">0.04</td>
<td align="char">169</td>
</tr>
<tr>
<td>ApoE</td>
<td align="char">−0.15</td>
<td align="char">0.05</td>
<td align="char">169</td>
</tr>
<tr>
<td>Right entorhinal thickness</td>
<td>n/a</td>
<td>n/a</td>
<td>n/a</td>
<td>n/a</td>
</tr>
<tr>
<td>Left entorhinal thickness</td>
<td>n/a</td>
<td>n/a</td>
<td>n/a</td>
<td>n/a</td>
</tr>
<tr>
<td rowspan="2">Mean entorhinal volume</td>
<td>ApoC3</td>
<td align="char">−0.20</td>
<td align="char">0.01</td>
<td align="char">168</td>
</tr>
<tr>
<td>ApoE</td>
<td align="char">−0.18</td>
<td align="char">0.02</td>
<td align="char">169</td>
</tr>
<tr>
<td rowspan="4">Mean entorhinal thickness</td>
<td>ApoC3</td>
<td align="char">−0.22</td>
<td align="char">0.01</td>
<td align="char">168</td>
</tr>
<tr>
<td>ApoA1</td>
<td align="char">−0.21</td>
<td align="char">0.01</td>
<td align="char">169</td>
</tr>
<tr>
<td>ApoE</td>
<td align="char">−0.2</td>
<td align="char">0.01</td>
<td align="char">169</td>
</tr>
<tr>
<td>Prealbumin</td>
<td align="char">−0.15</td>
<td align="char">0.05</td>
<td align="char">158</td>
</tr>
<tr>
<td rowspan="3">Whole-brain volume</td>
<td>ApoE</td>
<td align="char">−0.19</td>
<td align="char">0.02</td>
<td align="char">145</td>
</tr>
<tr>
<td>ApoA1</td>
<td align="char">−0.19</td>
<td align="char">0.02</td>
<td align="char">145</td>
</tr>
<tr>
<td>AB40</td>
<td align="char">0.17</td>
<td align="char">0.04</td>
<td align="char">141</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Abbreviations: MRI, magnetic resonance imaging; MCI, mild cognitive impairment; AD, Alzheimer’s disease; NSE, neuron-specific enolase; RANTES, Regulated on Activation, Normal T Cell Expressed and Secreted; n/a, no significant association observed.</p>
</fn>
</table-wrap-foot>
<table-wrap-foot>
<fn id="tbl2fnlowast">
<label></label>
<p>Pearson's correlation coefficient.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tbl3" position="float">
<label>Table 3</label>
<caption>
<p>Proteins observed in the feature selection</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th>Protein</th>
<th>No. of times observed in feature selection</th>
<th>Protein</th>
<th>No. of times observed in feature selection</th>
</tr>
</thead>
<tbody>
<tr>
<td>
<bold>Transthyretin</bold>
</td>
<td align="char">5</td>
<td>CathepsinD</td>
<td align="char">1</td>
</tr>
<tr>
<td>
<bold>Clusterin</bold>
</td>
<td align="char">4</td>
<td>ApoE</td>
<td align="char">1</td>
</tr>
<tr>
<td>
<bold>Cystatin C</bold>
</td>
<td align="char">4</td>
<td>SAP</td>
<td align="char">0</td>
</tr>
<tr>
<td>
<bold>A1AcidG</bold>
</td>
<td align="char">4</td>
<td>Ceruloplasmin</td>
<td align="char">0</td>
</tr>
<tr>
<td>
<bold>ICAM1</bold>
</td>
<td align="char">4</td>
<td>NCAM</td>
<td align="char">0</td>
</tr>
<tr>
<td>
<bold>CC4</bold>
</td>
<td align="char">4</td>
<td>NSE</td>
<td align="char">0</td>
</tr>
<tr>
<td>
<bold>PEDF</bold>
</td>
<td align="char">4</td>
<td>VCAM1</td>
<td align="char">0</td>
</tr>
<tr>
<td>
<bold>A1AT</bold>
</td>
<td align="char">4</td>
<td>A2M</td>
<td align="char">0</td>
</tr>
<tr>
<td>
<bold>APOE genotype</bold>
</td>
<td align="char">3</td>
<td>B2M</td>
<td align="char">0</td>
</tr>
<tr>
<td>
<bold>RANTES</bold>
</td>
<td align="char">3</td>
<td>BDNF</td>
<td align="char">0</td>
</tr>
<tr>
<td>
<bold>ApoC3</bold>
</td>
<td align="char">3</td>
<td>CFH</td>
<td align="char">0</td>
</tr>
<tr>
<td>PAI-1</td>
<td align="char">2</td>
<td>ApoA1</td>
<td align="char">0</td>
</tr>
<tr>
<td>CRP</td>
<td align="char">2</td>
<td>Ab40</td>
<td align="char">0</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Abbreviations: NSE, neuron-specific enolase; SAP, serum amyloid P; CFH, complement factor H; CRP, C-reactive protein.</p>
<p>NOTE. Ranked according to the number of times a protein was observed in the feature selection. Proteins highlighted in bold were taken forward as the predictors for MCI conversion.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tbl4" position="float">
<label>Table 4</label>
<caption>
<p>Characteristics of the ROC curve for (A) the full data set without MRI and (B) ROC curve characteristics for the subset with MRI imaging data</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th colspan="8">(A) ROC characteristics without MRI
<hr></hr>
</th>
</tr>
<tr>
<th>Classification model</th>
<th>Sensitivity cut-off %</th>
<th>SN %</th>
<th>SP %</th>
<th>PPV %</th>
<th>NPV %</th>
<th>ACC %</th>
<th>ROC (AUC)</th>
</tr>
</thead>
<tbody>
<tr>
<td>Protein + APOE</td>
<td align="char">30</td>
<td align="char">30.8</td>
<td align="char">92.9</td>
<td align="char">57.1</td>
<td align="char">81.3</td>
<td align="char">87.2</td>
<td align="char">0.84</td>
</tr>
<tr>
<td>Protein only</td>
<td align="char">30</td>
<td align="char">30.8</td>
<td align="char">92.9</td>
<td align="char">57.1</td>
<td align="char">81.3</td>
<td align="char">87.2</td>
<td align="char">0.78</td>
</tr>
<tr>
<td>Protein + APOE</td>
<td align="char">50</td>
<td align="char">53.9</td>
<td align="char">88.1</td>
<td align="char">58.3</td>
<td align="char">86.1</td>
<td align="char">80.0</td>
<td align="char">0.84</td>
</tr>
<tr>
<td>Protein only</td>
<td align="char">50</td>
<td align="char">43.8</td>
<td align="char">84.6</td>
<td align="char">53.9</td>
<td align="char">78.6</td>
<td align="char">72.7</td>
<td align="char">0.78</td>
</tr>
<tr>
<td>Protein + APOE</td>
<td align="char">85</td>
<td align="char">84.6</td>
<td align="char">88.1</td>
<td align="char">68.8</td>
<td align="char">94.9</td>
<td align="char">87.2</td>
<td align="char">0.84</td>
</tr>
<tr>
<td>Protein only</td>
<td align="char">85</td>
<td align="char">84.6</td>
<td align="char">71.4</td>
<td align="char">47.8</td>
<td align="char">93.8</td>
<td align="char">74.5</td>
<td align="char">0.78</td>
</tr>
</tbody>
</table>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th colspan="8">(B) ROC characteristics with MRI
<hr></hr>
</th>
</tr>
<tr>
<th>Classification model</th>
<th>Sensitivity cut-off %</th>
<th>SN %</th>
<th>SP %</th>
<th>PPV %</th>
<th>NPV %</th>
<th>ACC %</th>
<th>ROC (AUC)</th>
</tr>
</thead>
<tbody>
<tr>
<td>Protein + APOE + MRI</td>
<td align="char">30</td>
<td align="char">33.3</td>
<td align="char">96.7</td>
<td align="char">66.7</td>
<td align="char">87.9</td>
<td align="char">86.1</td>
<td align="char">0.75</td>
</tr>
<tr>
<td>Protein only</td>
<td align="char">30</td>
<td align="char">33.3</td>
<td align="char">93.3</td>
<td align="char">50.0</td>
<td align="char">87.5</td>
<td align="char">83.3</td>
<td align="char">0.82</td>
</tr>
<tr>
<td>MRI only</td>
<td align="char">30</td>
<td align="char">33.3</td>
<td align="char">80.0</td>
<td align="char">25.0</td>
<td align="char">85.7</td>
<td align="char">72.2</td>
<td align="char">0.54</td>
</tr>
<tr>
<td>Protein + APOE + MRI</td>
<td align="char">50</td>
<td align="char">50.0</td>
<td align="char">90.0</td>
<td align="char">50.0</td>
<td align="char">90.0</td>
<td align="char">83.3</td>
<td align="char">0.75</td>
</tr>
<tr>
<td>Protein only</td>
<td align="char">50</td>
<td align="char">50.0</td>
<td align="char">86.7</td>
<td align="char">42.9</td>
<td align="char">89.7</td>
<td align="char">80.6</td>
<td align="char">0.82</td>
</tr>
<tr>
<td>MRI only</td>
<td align="char">50</td>
<td align="char">50.0</td>
<td align="char">63.3</td>
<td align="char">21.3</td>
<td align="char">86.4</td>
<td align="char">61.1</td>
<td align="char">0.54</td>
</tr>
<tr>
<td>Protein + APOE + MRI</td>
<td align="char">85</td>
<td align="char">83.3</td>
<td align="char">60.0</td>
<td align="char">29.4</td>
<td align="char">94.7</td>
<td align="char">63.9</td>
<td align="char">0.75</td>
</tr>
<tr>
<td>Protein only</td>
<td align="char">85</td>
<td align="char">83.3</td>
<td align="char">66.7</td>
<td align="char">33.3</td>
<td align="char">95.2</td>
<td align="char">69.4</td>
<td align="char">0.82</td>
</tr>
<tr>
<td>MRI only</td>
<td align="char">85</td>
<td align="char">83.3</td>
<td align="char">13.3</td>
<td align="char">16.1</td>
<td align="char">80.0</td>
<td align="char">25.0</td>
<td align="char">0.54</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Abbreviations: ROC, receiver operating characteristic; MRI, magnetic resonance imaging; SN, sensitivity; SP, specificity; PPV, positive predictive value; NPV, negative predictive value; ACC, accuracy; AUC, ROC area under curve for the protein and APOE classifiers.</p>
<p>NOTE. Three different sensitivity cut-off points were investigated.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Australie</li>
<li>Canada</li>
<li>Finlande</li>
<li>France</li>
<li>Grèce</li>
<li>Italie</li>
<li>Pologne</li>
<li>Royaume-Uni</li>
<li>Suède</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Grand Londres</li>
<li>Midi-Pyrénées</li>
<li>Missouri (État)</li>
<li>Occitanie (région administrative)</li>
<li>Oxfordshire</li>
<li>Svealand</li>
</region>
<settlement>
<li>Londres</li>
<li>Oxford</li>
<li>Stockholm</li>
<li>Toulouse</li>
</settlement>
<orgName>
<li>Université d'Oxford</li>
</orgName>
</list>
<tree>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Hye, Abdul" sort="Hye, Abdul" uniqKey="Hye A" first="Abdul" last="Hye">Abdul Hye</name>
</region>
<name sortKey="Ashton, Nicholas J" sort="Ashton, Nicholas J" uniqKey="Ashton N" first="Nicholas J." last="Ashton">Nicholas J. Ashton</name>
<name sortKey="Baird, Alison L" sort="Baird, Alison L" uniqKey="Baird A" first="Alison L." last="Baird">Alison L. Baird</name>
<name sortKey="Bazenet, Chantal" sort="Bazenet, Chantal" uniqKey="Bazenet C" first="Chantal" last="Bazenet">Chantal Bazenet</name>
<name sortKey="Dobson, Richard" sort="Dobson, Richard" uniqKey="Dobson R" first="Richard" last="Dobson">Richard Dobson</name>
<name sortKey="Keohane, Aoife" sort="Keohane, Aoife" uniqKey="Keohane A" first="Aoife" last="Keohane">Aoife Keohane</name>
<name sortKey="Leung, Rufina" sort="Leung, Rufina" uniqKey="Leung R" first="Rufina" last="Leung">Rufina Leung</name>
<name sortKey="Lovestone, Simon" sort="Lovestone, Simon" uniqKey="Lovestone S" first="Simon" last="Lovestone">Simon Lovestone</name>
<name sortKey="Lovestone, Simon" sort="Lovestone, Simon" uniqKey="Lovestone S" first="Simon" last="Lovestone">Simon Lovestone</name>
<name sortKey="Lunnon, Katie" sort="Lunnon, Katie" uniqKey="Lunnon K" first="Katie" last="Lunnon">Katie Lunnon</name>
<name sortKey="Lupton, Michelle" sort="Lupton, Michelle" uniqKey="Lupton M" first="Michelle" last="Lupton">Michelle Lupton</name>
<name sortKey="Pike, Ian" sort="Pike, Ian" uniqKey="Pike I" first="Ian" last="Pike">Ian Pike</name>
<name sortKey="Richardson, Jill" sort="Richardson, Jill" uniqKey="Richardson J" first="Jill" last="Richardson">Jill Richardson</name>
<name sortKey="Riddoch Contreras, Joanna" sort="Riddoch Contreras, Joanna" uniqKey="Riddoch Contreras J" first="Joanna" last="Riddoch-Contreras">Joanna Riddoch-Contreras</name>
<name sortKey="Sattlecker, Martina" sort="Sattlecker, Martina" uniqKey="Sattlecker M" first="Martina" last="Sattlecker">Martina Sattlecker</name>
<name sortKey="Simmons, Andrew" sort="Simmons, Andrew" uniqKey="Simmons A" first="Andrew" last="Simmons">Andrew Simmons</name>
<name sortKey="Ward, Malcolm" sort="Ward, Malcolm" uniqKey="Ward M" first="Malcolm" last="Ward">Malcolm Ward</name>
<name sortKey="Westman, Eric" sort="Westman, Eric" uniqKey="Westman E" first="Eric" last="Westman">Eric Westman</name>
<name sortKey="Zucht, Hans Dieter" sort="Zucht, Hans Dieter" uniqKey="Zucht H" first="Hans Dieter" last="Zucht">Hans Dieter Zucht</name>
</country>
<country name="Suède">
<region name="Svealand">
<name sortKey="Westman, Eric" sort="Westman, Eric" uniqKey="Westman E" first="Eric" last="Westman">Eric Westman</name>
</region>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Lupton, Michelle" sort="Lupton, Michelle" uniqKey="Lupton M" first="Michelle" last="Lupton">Michelle Lupton</name>
</noRegion>
</country>
<country name="États-Unis">
<region name="Missouri (État)">
<name sortKey="Pepin, Danielle" sort="Pepin, Danielle" uniqKey="Pepin D" first="Danielle" last="Pepin">Danielle Pepin</name>
</region>
<name sortKey="Tunnicliffe, Alan" sort="Tunnicliffe, Alan" uniqKey="Tunnicliffe A" first="Alan" last="Tunnicliffe">Alan Tunnicliffe</name>
<name sortKey="Zheng, Wei" sort="Zheng, Wei" uniqKey="Zheng W" first="Wei" last="Zheng">Wei Zheng</name>
</country>
<country name="Canada">
<noRegion>
<name sortKey="Gauthier, Serge" sort="Gauthier, Serge" uniqKey="Gauthier S" first="Serge" last="Gauthier">Serge Gauthier</name>
</noRegion>
</country>
<country name="Finlande">
<noRegion>
<name sortKey="Soininen, Hilkka" sort="Soininen, Hilkka" uniqKey="Soininen H" first="Hilkka" last="Soininen">Hilkka Soininen</name>
</noRegion>
</country>
<country name="Pologne">
<noRegion>
<name sortKey="Kloszewska, Iwona" sort="Kloszewska, Iwona" uniqKey="Kloszewska I" first="Iwona" last="Kłoszewska">Iwona Kłoszewska</name>
</noRegion>
</country>
<country name="Italie">
<noRegion>
<name sortKey="Mecocci, Patrizia" sort="Mecocci, Patrizia" uniqKey="Mecocci P" first="Patrizia" last="Mecocci">Patrizia Mecocci</name>
</noRegion>
</country>
<country name="Grèce">
<noRegion>
<name sortKey="Tsolaki, Magda" sort="Tsolaki, Magda" uniqKey="Tsolaki M" first="Magda" last="Tsolaki">Magda Tsolaki</name>
</noRegion>
</country>
<country name="France">
<region name="Occitanie (région administrative)">
<name sortKey="Vellas, Bruno" sort="Vellas, Bruno" uniqKey="Vellas B" first="Bruno" last="Vellas">Bruno Vellas</name>
</region>
</country>
</tree>
</affiliations>
</record>

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