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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
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Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies
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Biomarkers.

Gregory Mathoux1, Cecilia Boccalini2, Débora E Peretti3

  • 1Geneva University Hospitals, Geneva, Switzerland.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
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Summary
This summary is machine-generated.

The Centiloid scale needs refined thresholds for accurate amyloid PET interpretation. A three-level system (NEGATIVE, GRAY-ZONE, POSITIVE) better predicts cognitive decline and tau pathology, aiding personalized dementia treatment.

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Area of Science:

  • Neurology
  • Nuclear Medicine
  • Biomarkers

Background:

  • The Centiloid (CL) scale standardizes amyloid PET imaging across studies.
  • Varying positivity thresholds complicate risk identification for cognitive decline and specific pathologies.
  • This study aims to define optimal CL thresholds for a three-level classification system.

Purpose of the Study:

  • To establish optimal Centiloid (CL) thresholds for a three-level classification system (NEGATIVE, GRAY-ZONE, POSITIVE).
  • To validate these thresholds in distinguishing tau pathology, cognitive status, and clinical outcomes.
  • To improve risk stratification and personalized treatment strategies in memory clinic cohorts.

Main Methods:

  • 580 participants underwent amyloid PET scans; subsets had tau PET and CSF analysis.
  • Participants classified as NEGATIVE (CL<12), GRAY-ZONE (12≤CL≤37), or POSITIVE (CL>37).
  • Statistical analyses (Chi-squared, Kruskal-Wallis, linear mixed-effects models, ROC) assessed associations and prognostic implications.

Main Results:

  • Predefined thresholds effectively stratified participants, with 44% of GRAY-ZONE showing discordant visual classification.
  • CSF and tau levels differed significantly across groups (p<0.01), with GRAY-ZONE showing intermediate characteristics.
  • Optimal CL thresholds (e.g., 13 for decline, 14/51 for tau) were identified via ROC analysis, linking lower thresholds to early tau and higher thresholds to advanced pathology.

Conclusions:

  • Moving beyond binary amyloid classification is crucial, with at least three meaningful levels identified.
  • The GRAY-ZONE group exhibits distinct clinical and biomarker profiles.
  • Refined CL thresholds aid in identifying individuals at risk for cognitive decline and specific tau pathologies, crucial for personalized therapies.