BMJ Neurology Open (Aug 2022)

Different AT(N) profiles and clinical progression classified by two different N markers using total tau and neurofilament light chain in cerebrospinal fluid

  • ,
  • Takashi Sakurai,
  • Kengo Ito,
  • Koichi Kozaki,
  • Kenji Toba,
  • Hiroshige Fujishiro,
  • Masanori Nakagawa,
  • Kazuo Ogawa,
  • Hiroshi Yamauchi,
  • Chio Okuyama,
  • Hiroshi Ito,
  • Daisuke Watanabe,
  • Satoshi Koyama,
  • Ryosuke Takahashi,
  • Kazunori Terasaki,
  • Harushi Mori,
  • Tetsuya Maeda,
  • Masaru Suzuki,
  • Masatoyo Nishizawa,
  • Mikio Shoji,
  • Mineo Yamazaki,
  • Etsuro Matsubara,
  • Shuichi Ikeda,
  • Hidehiro Mizusawa,
  • Kenji Nakashima,
  • Jun Takeuchi,
  • Hiroyuki Shimada,
  • Takashi Kudo,
  • Nobuyuki Saito,
  • Hiroyuki Arai,
  • Takashi Yamazaki,
  • Mitsutoshi Okazaki,
  • Takeshi Iwatsubo,
  • Nobuo Sanjo,
  • Masaki Takao,
  • Shigeo Murayama,
  • Masahito Yamada,
  • Yuichi Sato,
  • Satoshi Takahashi,
  • Harumasa Takano,
  • Masuhiro Sakata,
  • Shunji Mugikura,
  • Shun Shimohama,
  • Takashi Kato,
  • Toshiki Mizuno,
  • Yukiko Yamada,
  • Daisuke Yamamoto,
  • Makoto Higuchi,
  • Yu Nakamura,
  • Yu Hayasaka,
  • Yoshiko Fukushima,
  • Takayuki Obata,
  • Kimiko Yoshimaru,
  • Shinichi Sakamoto,
  • Kaori Watanabe,
  • Masashi Tsujimoto,
  • Osamu Yokota,
  • Seishi Terada,
  • Atsushi Watanabe,
  • Akinori Miyashita,
  • Ryozo Kuwano,
  • Daisuke Yamaguchi,
  • Tetsuaki Arai,
  • Rieko Okada,
  • Hiroshi Matsuda,
  • Kyoko Ito,
  • Kenji Ishii,
  • Yukio Miki,
  • Yuka Yamamoto,
  • Toru Takahashi,
  • Makoto Sasaki,
  • Ken Nagata,
  • Hajime Sato,
  • Miwako Takahashi,
  • Toshimitsu Momose,
  • Isao Ito,
  • Masakazu Yamagishi,
  • Mayumi Watanabe,
  • Hitoshi Shibuya,
  • Shin-ichi Urayama,
  • Hidenao Fukuyama,
  • Toshio Kawamata,
  • Yasuji Yamamoto,
  • Kiyoshi Maeda,
  • Manabu Ikeda,
  • Mamoru Hashimoto,
  • Takeshi Kawarabayashi,
  • Masaki Ikeda,
  • Eizo Iseki,
  • Kazunari Ishii,
  • Yuko Saito,
  • Miharu Samuraki,
  • Heii Arai,
  • Takashi Asada,
  • Haruo Hanyu,
  • Katsuyoshi Mizukami,
  • Takahiko Tokuda,
  • Yukihiko Washimi,
  • Mitsuhiro Yoshita,
  • Hitoshi Shimada,
  • Fumitoshi Niwa,
  • Hitoshi Shinotoh,
  • Tetsuya Suhara,
  • Masatoshi Takeda,
  • YOKO KONAGAYA,
  • Takaaki Mori,
  • Kensaku Kasuga,
  • Takayoshi Tokutake,
  • Takeshi Ikeuchi,
  • Hiroaki Kazui,
  • Noriko Sato,
  • Takeshi Tamaru,
  • Masanobu Takahashi,
  • Yasuhiro Nakata,
  • Yasumasa Yoshiyama,
  • Hisatomo Kowa,
  • Shuichi Ono,
  • Takuya Ohkubo,
  • Yasuo Kuwabara,
  • Tomoko Nakazawa,
  • Kazutomi Kanemaru,
  • Toshiaki Taoka,
  • Nobuyuki Okamura,
  • Hiroki Hayashi,
  • Shin Tanaka,
  • Kayoko Kikuchi,
  • Masataka Kikuchi,
  • Tamao Tsukie,
  • Kazushi Suzuki,
  • Ryoko Ihara,
  • Atsushi Iwata,
  • Norikazu Hara,
  • Morihiro Sugishita,
  • Michio Senda,
  • Masaki Saitoh,
  • Rika Yamauchi,
  • Takashi Hayashi,
  • Seiju Kobayashi,
  • Norihito Nakano,
  • Junichiro Kanazawa,
  • Takeshi Ando,
  • Chiyoko Takanami,
  • Masato Hareyama,
  • Masamitsu Hatakenaka,
  • Eriko Tsukamoto,
  • Shinji Ochi,
  • Yasuhito Wakasaya,
  • Takashi Nakata,
  • Naoko Nakahata,
  • Yoshihiro Takai,
  • Hisashi Yonezawa,
  • Junko Takahashi,
  • Masako Kudoh,
  • Yutaka Matsumura,
  • Yohsuke Hirata,
  • Tsuyoshi Metoki,
  • Susumu Hayakawa,
  • Masayuki Takeda,
  • Toshiaki Sasaki,
  • Koichiro Sera,
  • Yoshihiro Saitoh,
  • Shoko Goto,
  • Kuniko Ueno,
  • Hiromi Sakashita,
  • Kuniko Watanabe,
  • Yasushi Kondoh,
  • Daiki Takano,
  • Mio Miyata,
  • Hiromi Komatsu,
  • Tomomi Sinoda,
  • Rena Muraoka,
  • Hitomi Ito,
  • Aki Sato,
  • Toshibumi Kinoshita,
  • Hideyo Toyoshima,
  • Kaoru Sato,
  • Shigeki Sugawara,
  • Fumiko Kumagai,
  • Katsutoshi Furukawa,
  • Masaaki Waragai,
  • Naoki Tomita,
  • Mari Ootsuki,
  • Katsumi Sugawara,
  • Satomi Sugawara,
  • Atsushi Umetsu,
  • Takanori Murata,
  • Tatsuo Nagasaka,
  • Yukitsuka Kudo,
  • Manabu Tashiro,
  • Shoichi Watanuki,
  • Saeri Ishikawa,
  • Emiko Kishida,
  • Nozomi Sato,
  • Mieko Hagiwara,
  • Kumi Yamanaka,
  • Takeyuki Watanabe,
  • Taeko Takasugi,
  • Shoichi Inagawa,
  • Kenichi Naito,
  • Masanori Awaji,
  • Tsutomu Kanazawa,
  • Kouiti Okamoto,
  • Tsuneo Yamazaki,
  • Yuiti Tasiro,
  • Syunn Nagamine,
  • Shiori Katsuyama,
  • Sathiko Kurose,
  • Sayuri Fukushima,
  • Etsuko Koya,
  • Makoto Amanuma,
  • Noboru Oriuti,
  • Kouiti Ujita,
  • Kazuhiro Kishi,
  • Kazuhisa Tuda,
  • Etsuko Nakajima,
  • Katsumi Miyamoto,
  • Kousaku Saotome,
  • Tomoya Kobayashi,
  • Saori Itoya,
  • Jun Ookubo,
  • Toshiya Akatsu,
  • Yoshiko Anzai,
  • Junya Ikegaki,
  • Yuuichi Katou,
  • Kaori Kimura,
  • Ryou Kuchii,
  • Hajime Saitou,
  • Kazuya Shinoda,
  • Satoka Someya,
  • Hiroko Taguchi,
  • Kazuya Tashiro,
  • Masaya Tanaka,
  • Tatsuya Nemoto,
  • Ryou Wakabayashi,
  • Hitoshi Shinoto,
  • Kazuko Suzuki,
  • Izumi Izumida,
  • Katsuyuki Tanimoto,
  • Takahiro Shiraishi,
  • Junko Shiba,
  • Hiroaki Yano,
  • Miki Satake,
  • Aimi Nakui,
  • Yae Ebihara,
  • Tomomi Hasegawa,
  • Mami Kato,
  • Yuki Ogata,
  • Hiroyuki Fujikawa,
  • Nobuo Araki,
  • Yoshihiko Nakazato,
  • Takahiro Sasaki,
  • Tomokazu Shimadu,
  • Etsuko Imabayashi,
  • Asako Yasuda,
  • Etuko Yamamoto,
  • Natsumi Nakamata,
  • Noriko Miyauchi,
  • Keiko Ozawa,
  • Rieko Hashimoto,
  • Taishi Unezawa,
  • Takafumi Ichikawa,
  • Tunemichi Mihara,
  • Masaya Hirano,
  • Shinichi Watanabe,
  • Junichiro Fukuhara,
  • Hajime Matsudo,
  • Toshihiro Hayashi,
  • Toji Miyagawa,
  • Mizuho Yoshida,
  • Yuri Koide,
  • Eriko Samura,
  • Kurumi Fujii,
  • Nagae Orihara,
  • Akira Kunimatsu,
  • Takuya Arai,
  • Yoshiki Kojima,
  • Masami Goto,
  • Takeo Sarashina,
  • Syuichi Uzuki,
  • Seiji Katou,
  • Yoshiharu Sekine,
  • Yukihiro Takauchi,
  • Chiine Kagami,
  • Yasushi Nishina,
  • Maria Sakaibara,
  • Yumiko Okazaki,
  • Maki Obata,
  • Yuko Iwata,
  • Mizuho Minami,
  • Yasuko Hanabusa,
  • Hanae Shingyouji,
  • Kyoko Tottori,
  • Aya Tokumaru,
  • Makoto Ichinose,
  • Kazuya Kume,
  • Syunsuke Kahashi,
  • Kunimasa Arima,
  • Tadashi Tukamoto,
  • Yuko Nagahusa,
  • Maki Yamada,
  • Tiine Kodama,
  • Tomoko Takeuchi,
  • Keiichiro Ozawa,
  • Yoshiko Kawaji,
  • Kyouko Tottori,
  • Satoshi Sawada,
  • Makoto Mimatsu,
  • Daisuke Nakkamura,
  • Shunichirou Horiuchi,
  • Tsuneyoshi Ota,
  • Aiko Kodaka,
  • Yuko Tagata,
  • Tomoko Nakada,
  • Kiyoshi Sato,
  • Norio Murayama,
  • Satoshi Kimura,
  • Hirofumi Sakurai,
  • Takahiko Umahara,
  • Hidekazu Kanetaka,
  • Kaori Arashino,
  • Mikako Murakami,
  • Ai Kito,
  • Seiko Miyagi,
  • Kaori Doi,
  • Kazuyoshi Sasaki,
  • Akiko Ishiwata,
  • Yasushi Arai,
  • Akane Nogami,
  • Sumiko Fukuda,
  • Sayaka Kimura,
  • Ayako Machida,
  • Kuninori Kobayashi,
  • Mutsufusa Watanabe,
  • Hiromi Utashiro,
  • Yukiko Matsumoto,
  • Kumiko Hagiya,
  • Yoshiko Miyama,
  • Takako Shinozaki,
  • Haruko Hiraki,
  • Isamu Ohashi,
  • Akira Toriihara,
  • Shinichi Ohtani,
  • Toshifumi Matsui,
  • Tomomi Toyama,
  • Hideki Sakurai,
  • Kumiko Sugiura,
  • Hirofumi Taguchi,
  • Shizuo Hatashita,
  • Akari Imuta,
  • Akiko Matsudo,
  • Daichi Wakebe,
  • Hideki Hayakawa,
  • Mitsuhiro Ono,
  • Takayoshi Ohara,
  • Yutaka Arahata,
  • Akinori Takeda,
  • Akiko Yamaoka,
  • Hideyuki Hattori,
  • Miura Hisayuki,
  • Hidetoshi Endou,
  • Syousuke Satake,
  • Young Jae Hong,
  • Katsunari Iwai,
  • Kenji Yoshiyama,
  • Masaki Suenaga,
  • Sumiko Morita,
  • Teruhiko Kachi,
  • Rina Miura,
  • Takiko Kawai,
  • Ai Honda,
  • Kengo Itou,
  • Ken Fujiwara,
  • Rikio Katou,
  • Mariko Koyama,
  • Naohiko Fukaya,
  • Akira Tsuji,
  • Hitomi Shimizu,
  • Hiroyuki Fujisawa,
  • Takanori Sakata,
  • Kenjiro Ono,
  • Moeko Shinohara,
  • Yuki Soshi,
  • Kozue Niwa,
  • Chiaki Doumoto,
  • Mariko Hata,
  • Miyuki Matsushita,
  • Mai Tsukiyama,
  • Nozomi Takeda,
  • Sachiko Yonezawa,
  • Ichiro Matsunari,
  • Osamu Matsui,
  • Fumiaki Ueda,
  • Yasuji Ryu,
  • Masanobu Sakamoto,
  • Yasuomi Ouchi,
  • Madoka Chita,
  • Yumiko Fujita,
  • Rika Majima,
  • Hiromi Tsubota,
  • Umeo Shirasawa,
  • Masashi Sugimori,
  • Wataru Ariya,
  • Yuuzou Hagiwara,
  • Yasuo Tanizaki,
  • Hajime Takechi,
  • Chihiro Namiki,
  • Kengo Uemura,
  • Takeshi Kihara,
  • Shizuko Tanaka-Urayama,
  • Emiko Maeda,
  • Natsu Saito,
  • Shiho Satomi,
  • Konomi Kabata,
  • Tomohisa Okada,
  • Koichi Ishizu,
  • Shigeto Kawase,
  • Satoshi Fukumoto,
  • Masaki Kondo,
  • Yoko Oishi,
  • Mariko Yamazaki,
  • Yoku Asano,
  • Chizuru Hamaguchi,
  • Kei Yamada,
  • Kentaro Akazawa,
  • Shigenori Matsushima,
  • Takamasa Matsuo,
  • Toshiaki Nakagawa,
  • Takeshi Nii,
  • Takuji Nishida,
  • Kuniaki Kiuchi,
  • Masami Fukusumi,
  • Hideyuki Watanabe,
  • Akihiro Nogi,
  • Toshihisa Tanaka,
  • Naoyuki Sato,
  • Masayasu Okochi,
  • Takashi Morihara,
  • Shinji Tagami,
  • Noriyuki Hayashi,
  • Masahiko Takaya,
  • Tamiki Wada,
  • Mikiko Yokokoji,
  • Hiromichi Sugiyama,
  • Shuko Takeda,
  • Keiko Nomura,
  • Mutsumi Tomioka,
  • Eiichi Uchida,
  • Yoshiyuki Ikeda,
  • Mineto Murakami,
  • Takami Miki,
  • Suzuka Ataka,
  • Motokatsu Kanemoto,
  • Akitoshi Takeda,
  • Rie Azuma,
  • Yuki Iwamoto,
  • Naomi Tagawa,
  • Junko Masao,
  • Yuka Matsumoto,
  • Yuko Kikukawa,
  • Hisako Fujii,
  • Junko Matsumura,
  • Susumu Shiomi,
  • Joji Kawabe,
  • Yoshihiro Shimonishi,
  • Mitsuji Higashida,
  • Tomohiro Sahara,
  • Takashi Yamanaga,
  • Hiroyuki Tsushima,
  • Kazuo Sakai,
  • Haruhiko Oda,
  • Taichi Akisaki,
  • Mizuho Adachi,
  • Masako Kuranaga,
  • Sachi Takegawa,
  • Yoshihiko Tahara,
  • Takeshi Ishihara,
  • Hajime Honda,
  • Yuki Kishimoto,
  • Naoya Takeda,
  • Nao Imai,
  • Mayumi Yabe,
  • Kentaro Ida,
  • Daigo Anami,
  • Seiji Inoue,
  • Toshi Matsushita,
  • Reiko Wada,
  • Shinsuke Hiramatsu,
  • Hiromi Tonbara,
  • Reiko Yamamoto,
  • Kenji Wada-Isoe,
  • Saori Yamasaki,
  • Eijiro Yamashita,
  • Ichiro Ishikawa,
  • Sonoko Danjo,
  • Tomomi Shinohara,
  • Miyuki Ueno,
  • Yuka Kashimoto,
  • Yoshihiro Nishiyama,
  • Narihide Kimura,
  • Yasuhiro Sasakawa,
  • Takashi Ishimori,
  • Yukito Maeda,
  • Tatsuo Yamada,
  • Shinji Ouma,
  • Aika Fukuhara-Kaneumi,
  • Nami Sakamoto,
  • Rie Nagao,
  • Kengo Yoshimitsu,
  • Ryuji Nakamuta,
  • Minoru Tanaka,
  • Keiichirou Kaneda,
  • Yuusuke Yatabe,
  • Kazuki Honda,
  • Naoko Ichimi,
  • Fumi Akatuka,
  • Mariko Morinaga,
  • Miyako Noda,
  • Mika Kitajima,
  • Toshinori Hirai,
  • Shinya Shiraishi,
  • Naoji Amano,
  • Shinsuke Washizuka,
  • Shin Inuzuka,
  • Tetsuya Hagiwara,
  • Nobuhiro Sugiyama,
  • Yatsuka Okada,
  • Tomomi Ogihara,
  • Takehiko Yasaki,
  • Minori Kitayama,
  • Tomonori Owa,
  • Akiko Ryokawa,
  • Rie Takeuchi,
  • Satoe Goto,
  • Keiko Yamauchi,
  • Mie Ito,
  • Tomoki Kaneko,
  • Hitoshi Ueda,
  • Ban Mihara,
  • Hirofumi Kubo,
  • Akiko Takano,
  • Gou Yasui,
  • Masami Akuzawa,
  • Kaori Yamaguchi,
  • Toshinari Odawara,
  • Megumi Shimamura,
  • Mikiko Sugiyama,
  • Naomi Oota,
  • Shigeo Takebayashi,
  • Yoshigazu Hayakawa,
  • Mitsuhiro Idegawa,
  • Noriko Toya

DOI
https://doi.org/10.1136/bmjno-2022-000321
Journal volume & issue
Vol. 4, no. 2

Abstract

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Background The AT(N) classification was proposed for categorising individuals according to biomarkers. However, AT(N) profiles may vary depending on the markers chosen and the target population.Methods We stratified 177 individuals who participated in the Japanese Alzheimer’s Disease Neuroimaging Initiative by AT(N) classification according to cerebrospinal fluid (CSF) biomarkers. We compared the frequency of AT(N) profiles between the classification using total tau and neurofilament light chain (NfL) as N markers (AT(N)tau and AT(N)NfL). Baseline characteristics, and longitudinal biological and clinical changes were examined between AT(N) profiles.Results We found that 9% of cognitively unimpaired subjects, 49% of subjects with mild cognitive impairment, and 61% of patients with Alzheimer’s disease (AD) dementia had the biological AD profile (ie, A+T+) in the cohort. The frequency of AT(N) profiles substantially differed between the AT(N)tau and AT(N)NfL classifications. When we used t-tau as the N marker (AT(N)tau), those who had T− were more frequently assigned to (N)−, whereas those who had T+were more frequently assigned to (N)+ than when we used NfL as the N marker (AT(N)NfL). During a follow-up, the AD continuum group progressed clinically and biologically compared with the normal biomarker group in both the AT(N)tau and AT(N)NfL classifications. More frequent conversion to dementia was observed in the non-AD pathological change group in the AT(N)tau classification, but not in the AT(N)NfL classification.Conclusions AT(N)tau and AT(N)NfL in CSF may capture different aspects of neurodegeneration and provide a different prognostic value. The AT(N) classification aids in understanding the AD continuum biology in various populations.