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Blood biomarkers confirm subjective cognitive decline (SCD) as a distinct molecular and clinical stage within the NIA-AA framework of Alzheimer´s disease

Title: Blood biomarkers confirm subjective cognitive decline (SCD) as a distinct molecular and clinical stage within the NIA-AA framework of Alzheimer´s disease
Authors: Mengel, D.; Soter, E.; Ott, J.M.; Wacker, M.; Leyva, A.; Peters, O.; Hellmann-Regen, J.; Schneider, L.S.; Wang, X.; Priller, J.; Spruth, E.; Altenstein, S.; Schneider, A.; Fliessbach, K.; Wiltfang, J.; Hansen, N.; Rostamzadeh, A.; Düzel, E.; Glanz, W.; Incesoy, E.I.; Buerger, K.; Janowitz, D.; Ewers, M.; Perneczky, R.; Rauchmann, B.; Teipel, S.; Kilimann, I.; Laske, C.; Sodenkamp, S.; Spottke, A.; Brustkern, J.; Brosseron, F.; Wagner, M.; Stark, M.; Kleineidam, L.; Shao, K.; Lüsebrink, F.; Yakupov, R.; Schmid, M.; Hetzer, S.; Dechent, P.; Scheffler, K.; Berron, D.; Jessen, F.; Synofzik, M.
Publisher Information: Nature Publishing Group
Publication Year: 2025
Collection: Max-Delbrueck-Center for Molecular Medicine, Berlin: MDC Repository
Subject Terms: Function and Dysfunction of the Nervous System; Topic 3: Integrative Biomedicine
Description: Subjective cognitive decline (SCD) is proposed as an indicator of transitional disease stage 2 in the Alzheimer’s disease (AD) continuum. However, molecular and particularly longitudinal fluid biomarker data for this stage are still limited. This study aimed to determine whether blood-based biomarkers in amyloid-positive individuals with SCD (A + SCD) support the notion of stage 2 as a distinct stage between stages 1 and 3 of AD and to identify those at high risk for clinical progression. In a prospective multicenter study (DELCODE) involving 457 participants across the AD continuum, we analyzed plasma phospho-tau 181 (p181) and neurofilament light chain (NfL) and assessed their association with longitudinal cognition, hippocampal atrophy, and AD clinical stage transition. The results showed that baseline plasma p181 levels were elevated and increased more rapidly in A + SCD individuals compared to amyloid-positive cognitively unimpaired (A + CU) individuals (stage 1). NfL levels rose across A + CU, A + SCD, and amyloid-positive mild cognitive impairment (A + MCI, stage 3). In A + SCD, but not in A + CU, higher p181 levels predicted cognitive decline (PACC5) and transition to MCI. In conclusion, plasma p181 provides molecular biomarker evidence supporting A + SCD as a pre-dementia AD stage (stage 2) distinct from A + CU (stage 1) and helps identify individuals at risk for cognitive decline early in the AD continuum.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: https://edoc.mdc-berlin.de/id/eprint/25299/1/25299oa.pdf; https://edoc.mdc-berlin.de/id/eprint/25299/2/25299suppl.pdf; Blood biomarkers confirm subjective cognitive decline (SCD) as a distinct molecular and clinical stage within the NIA-AA framework of Alzheimer´s disease. Mengel, D., Soter, E., Ott, J.M., Wacker, M., Leyva, A., Peters, O., Hellmann-Regen, J., Schneider, L.S., Wang, X., Priller, J., Spruth, E., Altenstein, S., Schneider, A., Fliessbach, K., Wiltfang, J., Hansen, N., Rostamzadeh, A., Düzel, E., Glanz, W., Incesoy, E.I., Buerger, K., Janowitz, D., Ewers, M., Perneczky, R., Rauchmann, B., Teipel, S., Kilimann, I., Laske, C., Sodenkamp, S., Spottke, A., Brustkern, J., Brosseron, F., Wagner, M., Stark, M., Kleineidam, L., Shao, K., Lüsebrink, F., Yakupov, R., Schmid, M., Hetzer, S., Dechent, P., Scheffler, K., Berron, D., Jessen, F. and Synofzik, M. Molecular Psychiatry 30 (7): 3150-3159. July 2025; PMID:40247130; https://doi.org/10.1038/s41380-025-03021-0
DOI: 10.1038/s41380-025-03021-0
Availability: https://edoc.mdc-berlin.de/id/eprint/25299/; https://edoc.mdc-berlin.de/25299/; https://doi.org/10.1038/s41380-025-03021-0
Rights: cc_by_4
Accession Number: edsbas.82A5C4B7
Database: BASE