p-tau231 reflects earlier amyloid-driven changes in entorhinal cortex while p-tau217 reflects downstream neuronal involvement. The combination captures the full spectrum of amyloid-to-tau propagation resolution. However, the composite algorithm is not operationally defined, weighting schemes are unspecified, and temporal window evidence from natural disease course may not transfer to treatment kinetics. Addition of p-tau231 may increase assay complexity without proportional predictive gain.
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