دورية أكاديمية
أعرض في EDS

Plasma and cerebrospinal fluid ABeta42 for the differential diagnosis of Alzheimer's disease dementia in participants diagnosed with any dementia subtype in a specialist care setting.

التفاصيل البيبلوغرافية
العنوان: Plasma and cerebrospinal fluid ABeta42 for the differential diagnosis of Alzheimer's disease dementia in participants diagnosed with any dementia subtype in a specialist care setting.
المؤلفون: Kokkinou M; MRC London Institute of Medical Sciences, Imperial College London, London, UK., Beishon LC; Department of Cardiovascular Sciences, University of Leicester, Leicester, UK., Smailagic N; Institute of Public Health, University of Cambridge , Cambridge, UK., Noel-Storr AH; Radcliffe Department of Medicine, University of Oxford , Oxford, UK., Hyde C; Exeter Test Group, College of Medicine and Health, University of Exeter Medical School, University of Exeter, Exeter , UK., Ukoumunne O; NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK., Worrall RE; University of Oxford Medical School, Oxford, UK., Hayen A; Department of Psychology and Clinical Language Sciences, University of Reading, Reading, UK., Desai M; Department of Experimental Psychology, University of Oxford, Oxford, UK., Ashok AH; MRC London Institute of Medical Sciences, Imperial College London, London, UK.; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College , London, UK., Paul EJ; MRC London Institute of Medical Sciences, Imperial College London, London, UK.; Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College London, London, UK., Georgopoulou A; Department of Surgery and Cancer, Imperial College London, London, UK., Casoli T; Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy., Quinn TJ; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK., Ritchie CW; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
المصدر: The Cochrane database of systematic reviews [Cochrane Database Syst Rev] 2021 Feb 10; Vol. 2. Cochrane AN: CD010945. Date of Electronic Publication: 2021 Feb 10.
نوع المنشور: Journal Article; Meta-Analysis; Systematic Review
اللغة: English
بيانات الدورية: Publisher: Wiley Country of Publication: England NLM ID: 100909747 Publication Model: Electronic Cited Medium: Internet ISSN: 1469-493X (Electronic) Linking ISSN: 13616137 NLM ISO Abbreviation: Cochrane Database Syst Rev Subsets: MEDLINE
أسماء مطبوعة: Publication: 2004- : Chichester, West Sussex, England : Wiley
Original Publication: Oxford, U.K. ; Vista, CA : Update Software,
مواضيع طبية MeSH: Alzheimer Disease/*diagnosis , Amyloid beta-Peptides/*blood , Amyloid beta-Peptides/*cerebrospinal fluid , Peptide Fragments/*blood , Peptide Fragments/*cerebrospinal fluid, Alcoholism/complications ; Alzheimer Disease/blood ; Alzheimer Disease/cerebrospinal fluid ; Bias ; Biomarkers/blood ; Biomarkers/cerebrospinal fluid ; Cognitive Dysfunction/blood ; Cognitive Dysfunction/cerebrospinal fluid ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/etiology ; Confidence Intervals ; Creutzfeldt-Jakob Syndrome/blood ; Creutzfeldt-Jakob Syndrome/cerebrospinal fluid ; Creutzfeldt-Jakob Syndrome/diagnosis ; Dementia, Vascular/blood ; Dementia, Vascular/cerebrospinal fluid ; Dementia, Vascular/diagnosis ; Diagnosis, Differential ; Frontotemporal Dementia/blood ; Frontotemporal Dementia/cerebrospinal fluid ; Frontotemporal Dementia/diagnosis ; Humans ; Hydrocephalus, Normal Pressure/blood ; Hydrocephalus, Normal Pressure/cerebrospinal fluid ; Hydrocephalus, Normal Pressure/diagnosis ; Lewy Body Disease/blood ; Lewy Body Disease/cerebrospinal fluid ; Lewy Body Disease/diagnosis ; Likelihood Functions ; Sensitivity and Specificity
مستخلص: Background: Dementia is a syndrome that comprises many differing pathologies, including Alzheimer's disease dementia (ADD), vascular dementia (VaD) and frontotemporal dementia (FTD). People may benefit from knowing the type of dementia they live with, as this could inform prognosis and may allow for tailored treatment. Beta-amyloid (1-42) (ABeta42) is a protein which decreases in both the plasma and cerebrospinal fluid (CSF) of people living with ADD, when compared to people with no dementia. However, it is not clear if changes in ABeta42 are specific to ADD or if they are also seen in other types of dementia. It is possible that ABeta42 could help differentiate ADD from other dementia subtypes.
Objectives: To determine the accuracy of plasma and CSF ABeta42 for distinguishing ADD from other dementia subtypes in people who meet the criteria for a dementia syndrome.
Search Methods: We searched MEDLINE, and nine other databases up to 18 February 2020. We checked reference lists of any relevant systematic reviews to identify additional studies.
Selection Criteria: We considered cross-sectional studies that differentiated people with ADD from other dementia subtypes. Eligible studies required measurement of participant plasma or CSF ABeta42 levels and clinical assessment for dementia subtype.
Data Collection and Analysis: Seven review authors working independently screened the titles and abstracts generated by the searches. We collected data on study characteristics and test accuracy. We used the second version of the 'Quality Assessment of Diagnostic Accuracy Studies' (QUADAS-2) tool to assess internal and external validity of results. We extracted data into 2 x 2 tables, cross-tabulating index test results (ABeta42) with the reference standard (diagnostic criteria for each dementia subtype). We performed meta-analyses using bivariate, random-effects models. We calculated pooled estimates of sensitivity, specificity, positive predictive values, positive and negative likelihood ratios, and corresponding 95% confidence intervals (CIs). In the primary analysis, we assessed accuracy of plasma or CSF ABeta42 for distinguishing ADD from other mixed dementia types (non-ADD). We then assessed accuracy of ABeta42 for differentiating ADD from specific dementia types: VaD, FTD, dementia with Lewy bodies (DLB), alcohol-related cognitive disorder (ARCD), Creutzfeldt-Jakob disease (CJD) and normal pressure hydrocephalus (NPH). To determine test-positive cases, we used the ABeta42 thresholds employed in the respective primary studies. We then performed sensitivity analyses restricted to those studies that used common thresholds for ABeta42.
Main Results: We identified 39 studies (5000 participants) that used CSF ABeta42 levels to differentiate ADD from other subtypes of dementia. No studies of plasma ABeta42 met the inclusion criteria. No studies were rated as low risk of bias across all QUADAS-2 domains. High risk of bias was found predominantly in the domains of patient selection (28 studies) and index test (25 studies). The pooled estimates for differentiating ADD from other dementia subtypes were as follows: ADD from non-ADD: sensitivity 79% (95% CI 0.73 to 0.85), specificity 60% (95% CI 0.52 to 0.67), 13 studies, 1704 participants, 880 participants with ADD; ADD from VaD: sensitivity 79% (95% CI 0.75 to 0.83), specificity 69% (95% CI 0.55 to 0.81), 11 studies, 1151 participants, 941 participants with ADD; ADD from FTD: sensitivity 85% (95% CI 0.79 to 0.89), specificity 72% (95% CI 0.55 to 0.84), 17 studies, 1948 participants, 1371 participants with ADD; ADD from DLB: sensitivity 76% (95% CI 0.69 to 0.82), specificity 67% (95% CI 0.52 to 0.79), nine studies, 1929 participants, 1521 participants with ADD. Across all dementia subtypes, sensitivity was greater than specificity, and the balance of sensitivity and specificity was dependent on the threshold used to define test positivity.
Authors' Conclusions: Our review indicates that measuring ABeta42 levels in CSF may help differentiate ADD from other dementia subtypes, but the test is imperfect and tends to misdiagnose those with non-ADD as having ADD. We would caution against the use of CSF ABeta42 alone for dementia classification. However, ABeta42 may have value as an adjunct to a full clinical assessment, to aid dementia diagnosis.
(Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)
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المشرفين على المادة: 0 (Amyloid beta-Peptides)
0 (Biomarkers)
0 (Peptide Fragments)
0 (amyloid beta-protein (1-42))
تواريخ الأحداث: Date Created: 20210210 Date Completed: 20210316 Latest Revision: 20231111
رمز التحديث: 20231111
مُعرف محوري في PubMed: PMC8078224
DOI: 10.1002/14651858.CD010945.pub2
PMID: 33566374
قاعدة البيانات: MEDLINE
الوصف
تدمد:1469-493X
DOI:10.1002/14651858.CD010945.pub2