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WSC 2022 | Plasma p-tau as a biomarker for cerebral amyloid angiopathy diagnosis

Hsin-Hsi Tsai, MD, National Taiwan University Hospital, Taipei, Taiwan, shares her work looking at the value of blood biomarkers as surrogates for cerebral amyloid angiopathy (CAA) diagnosis. The imaging-based Boston criteria is the mainstay of CAA diagnosis. While detection of β-amyloid deposition in the cerebrovasculature is the only method for definite diagnosis, the presence of hemorrhagic markers on MRI allows a diagnosis of probable CAA in living patients. However, there are atypical scenarios where diagnosis is less definite. Amyloid-PET can also be used to reliably detect amyloid pathology, but its high cost and low availability worldwide limits its utility. For these reasons, the identification of blood-based biomarkers that can be used to support imaging evidence for CAA diagnosis would be of great value. In this study, plasma levels of total tau (t-tau), phosphorylated tau181 (p-tau181), Aβ42 and Aβ40 were assessed in 67 patients who had a spontaneous intracerebral hemorrhage (ICH). Of these 67, 20 were diagnosed with CAA based on the Boston criteria and amyloid-PET. It was found that patients with CAA had a higher tau burden compared to the 47 patients with hypertensive small vessel disease (SVD) who had a negative amyloid scan. Notably, p-tau181 demonstrated good diagnostic value if differentiating CAA from hypertensive SVD (AUC 0.79). This interview took place at the World Stroke Congress 2022 in Singapore.

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