Estimation of positron emission tomography amyloid load and related biomarkers in Alzheimer's disease using evoked potential tomography EEG: development and internal validation in a cross-sectional cohort

Alzheimers Res Ther. 2026 Jun 12;18(1):147. doi: 10.1186/s13195-026-02076-7.

Abstract

Background: Dementia affects over 50 million individuals globally, predominantly due to Alzheimer's disease (AD). Effective early detection and intervention remain clinical challenges, as there is a lack of unified, portable solutions to assess multiple biomarkers.

Methods: We evaluated Evoked Potential Tomography (EPT), an EEG-based method using a novel visual evoked potential protocol. An automated pipeline for EEG preprocessing, ERP extraction, feature selection, optimization, and regression modeling was developed to estimate key AD biomarkers: PET-amyloid standardized uptake value ratio (SUVR), CSF phosphorylated tau (p-tau181), Free and Cued Selective Reminding Test (FCSRT), and Mini-Mental State Examination (MMSE) scores.

Results: Regression models using ERP features from dementia participants demonstrated strong correlations (r = 0.8-0.94, p < 0.01) between predicted and true PET-amyloid SUVR, p-tau181, FCSRT, and MMSE values. In an independent external cohort, PET-amyloid SUVR predictions remained significantly associated with true values (r = 0.60, p < 0.01).

Discussion: Despite limitations, these preliminary results support EPT's potential as a sensitive and non-invasive method for estimating AD-related biomarkers in a clinically enriched AD cohort. Further validation studies are ongoing.

Keywords: AD biomarkers; Alzheimer’s disease; Electroencephalography; Event-related potential; PET-amyloid SUVR; Regression modeling.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease* / diagnostic imaging
  • Alzheimer Disease* / metabolism
  • Alzheimer Disease* / physiopathology
  • Amyloid beta-Peptides* / metabolism
  • Biomarkers / metabolism
  • Brain* / diagnostic imaging
  • Brain* / metabolism
  • Brain* / physiopathology
  • Cohort Studies
  • Cross-Sectional Studies
  • Electroencephalography* / methods
  • Female
  • Humans
  • Male
  • Positron-Emission Tomography* / methods
  • tau Proteins / cerebrospinal fluid

Substances

  • Biomarkers
  • tau Proteins
  • Amyloid beta-Peptides