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Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies

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Biomarkers.

Qian Chen¹, Bing Zhang²

¹Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association

|December 24, 2025

Summary

This summary is machine-generated.

Early Alzheimer's disease (AD) changes in the nucleus basalis of Meynert (NBM) cholinergic pathways are linked to plasma phosphorylated tau 217 (ptau217). These imaging markers may help identify preclinical AD with elevated ptau217.

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Area of Science:

Neuroimaging
Biomarkers
Alzheimer's Disease Research

Background:

The nucleus basalis of Meynert (NBM) is an early site of Alzheimer's disease (AD) pathology.
Cholinergic pathways from the NBM project to the cortex and are affected early in AD.
The relationship between NBM imaging markers and plasma phosphorylated tau 217 (ptau217), an AD Core 1 biomarker, is not well understood.

Purpose of the Study:

To investigate the association between NBM multimodal imaging markers and plasma ptau217 levels.
To explore the role of NBM cholinergic white matter degeneration in preclinical AD identification.

Main Methods:

Fifty-nine cognitively unimpaired elderly individuals were grouped by plasma ptau217 levels (higher vs. lower than mean).
NBM volume, cholinergic white matter integrity (using fractional anisotropy and mean diffusivity), and functional connectivity were assessed.
Correlation, mediation, and ROC analyses were performed.

Main Results:

Individuals with higher plasma ptau217 showed reduced white matter integrity in NBM cholinergic pathways.
NBM and hippocampal volumes, and functional connectivity did not differ between groups.
Cholinergic white matter integrity mediated the relationship between plasma ptau217 and cognitive functions (memory, executive function).

Conclusions:

MRI-derived measures of NBM cholinergic white matter degeneration correlate with elevated plasma ptau217.
These imaging markers may help identify early AD pathological events before cognitive impairment.
NBM cholinergic white matter integrity shows potential as a preclinical AD biomarker.