Dement Neurocogn Disord.  2014 Dec;13(4):129-138. 10.12779/dnd.2014.13.4.129.

Efficacy of the Phosphorylated tau 181 in Differential Diagnosis of the Alzheimer's Disease: A Systematic Review and Meta-Analysis

• Mo JA
• Jang JW
• Lim JH
• Lee M
• Sul AR
• Kim HJ
• Youn YC

• KMID: 2443078
• DOI: http://doi.org/10.12779/dnd.2014.13.4.129

Abstract

BACKGROUND
The purpose of this study was to evaluate the value of phosphorylated tau with epitopes threonine 181(p-tau181) in cerebrospinal fluid (CSF) for the differential diagnosis of Alzheimer's disease typed dementia from other type of dementia.
METHODS
A systematic literature search was performed to identify studies on p-tau181. Two evaluators independently evaluated the quality of the ten studies using the Scottish Intercollegiate Guidelines Network (SIGN) tool. The literature review covered from October 27, 1946 to October 22, 2013, and eight domestic databases including KoreaMed and international databases including Ovid-MEDLINE, EMBASE, and Cochrane Library were used. Tau concentrations were compared to healthy controls and to subjects with Alzheimer's disease (AD) using random effect meta-analysis. Outcome measures were Cohen's delta, sensitivity and specificity.
RESULTS
Finally, 8 studies (8 diagnostic evaluation studies) were identified to evaluate CSF p-tau181. The effectiveness of this test was evaluated based on diagnostic accuracy. The diagnostic accuracy for identifying AD by ELISA was high which revealed pooled sensitivity as 0.843 (95% CI 0.818-0.867), pooled specificity as 0.799(95% CI 0.768-0.828) and summary receiver operating characteristic area under the curve 0.9082+/-0.0236.
CONCLUSIONS
CSF p-tau181 concentrations in other type of dementia are intermediate between controls and AD patients. Overlap between both controls and AD patients results in insufficient diagnostic accuracy, and the development of more specific biomarkers for these disorders is needed.

Keyword

Alzheimer's disease; Cerebrospinal fluid; Tau protein; Meta-analysis; Systemic review

MeSH Terms

Alzheimer Disease*
Biomarkers
Cerebrospinal Fluid
Dementia
Diagnosis, Differential*
Enzyme-Linked Immunosorbent Assay
Epitopes
Humans
Outcome Assessment (Health Care)
ROC Curve
Sensitivity and Specificity
tau Proteins
Threonine
Epitopes
Threonine
tau Proteins

Figure

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  Fig. 1 Flow diagram processed on the article selection.

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  Fig. 2 95% confidence interval of each clinical group using mean value and standard deviation.

• 

  Fig. 3 Funnel plot of selected studies.

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  Fig. 4 Forest plot of sensitivities and specificities and Receiver operating characteristics (ROC) curve.

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