In this prospective cohort study of 572 patients across the cognitive spectrum, a sequential blood biomarker strategy—using plasma p-tau217 (core 1) followed by eMTBR-tau243 (core 2)—improved diagnostic precision for Alzheimer’s disease. While p-tau217 reliably identified amyloid pathology, it lacked specificity for symptomatic disease; adding eMTBR-tau243 better distinguished clinically relevant AD (tau-driven neurodegeneration), correlated with tau PET burden and longitudinal cognitive decline, and enabled stratification by disease severity and potential treatment responsiveness.

Source: Nature Medicine