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Improving CSF Biomarkers' Performance for Predicting Progression from Mild Cognitive Impairment to Alzheimer's Disease by Considering Different Confounding Factors: A Meta-Analysis.

Ferreira D, Rivero-Santana A, Perestelo-Pérez L, Westman E, Wahlund LO, Sarría A, Serrano-Aguilar P - Front Aging Neurosci (2014)

Bottom Line: By considering several confounding factors we aimed to identify in which situations these CSF biomarkers can be useful.The p-tau had high capacity to identify MCI cases converting to AD in ≤24 months.Explaining how different confounding factors influence CSF biomarkers' predictive performance is mandatory to elaborate a definitive map of situations, where these CSF biomarkers are useful both in clinics and research.

View Article: PubMed Central - PubMed

Affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden.

ABSTRACT

Background: Cerebrospinal fluid (CSF) biomarkers' performance for predicting conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) is still suboptimal.

Objective: By considering several confounding factors we aimed to identify in which situations these CSF biomarkers can be useful.

Data sources: A systematic review was conducted on MEDLINE, PreMedline, EMBASE, PsycInfo, CINAHL, Cochrane, and CRD (1990-2013).

Eligibility criteria: (1) Prospective studies of CSF biomarkers' performance for predicting conversion from MCI to AD/dementia; (2) inclusion of Aβ42 and T-tau and/or p-tau. Several meta-analyses were performed.

Results: Aβ42/p-tau ratio had high capacity to predict conversion to AD in MCI patients younger than 70 years. The p-tau had high capacity to identify MCI cases converting to AD in ≤24 months.

Conclusions: Explaining how different confounding factors influence CSF biomarkers' predictive performance is mandatory to elaborate a definitive map of situations, where these CSF biomarkers are useful both in clinics and research.

No MeSH data available.


Related in: MedlinePlus

Study selection flow.
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Figure 1: Study selection flow.

Mentions: Inclusion criteria for this meta-analysis were studies that (1) performed a prospective analysis of the CSF biomarkers’ performance for predicting conversion to AD or dementia in individuals with MCI at baseline; (2) included at least two CSF biomarkers, being Aβ42 always required along with T-tau and/or p-tau; and (3) were published in English or Spanish. Studies were excluded if they did not report sensitivity or specificity values, or any other data that enabled its calculation. Two reviewers independently performed the study selection (Daniel Ferreira and Amado Rivero-Santana), and in case of doubt and/or disagreements a third reviewer was consulted (Lilisbeth Perestelo-Pérez). The search yielded 1308 references after discarding duplicates. One-hundred fifty-eight articles were selected by title and abstract. After applying eligibility criteria, 12 articles were eventually included (Hampel et al., 2004; Herukka et al., 2005; Parnetti et al., 2006, 2012; Eckerström et al., 2010; Hertze et al., 2010; Monge-Argilés et al., 2011; Buchhave et al., 2012; Ewers et al., 2012; Gaser et al., 2013; Toledo et al., 2013; Vos et al., 2013). Three of these studies included data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). As these studies represent different analyses of overlapping ADNI subsamples, only one ADNI study was included for each meta-analysis depending on the analyzed biomarker. If two ADNI studies were available for the same biomarker, the one with largest sample was selected. Selection flow including reasons for study exclusion at each phase is shown in Figure 1.


Improving CSF Biomarkers' Performance for Predicting Progression from Mild Cognitive Impairment to Alzheimer's Disease by Considering Different Confounding Factors: A Meta-Analysis.

Ferreira D, Rivero-Santana A, Perestelo-Pérez L, Westman E, Wahlund LO, Sarría A, Serrano-Aguilar P - Front Aging Neurosci (2014)

Study selection flow.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4199277&req=5

Figure 1: Study selection flow.
Mentions: Inclusion criteria for this meta-analysis were studies that (1) performed a prospective analysis of the CSF biomarkers’ performance for predicting conversion to AD or dementia in individuals with MCI at baseline; (2) included at least two CSF biomarkers, being Aβ42 always required along with T-tau and/or p-tau; and (3) were published in English or Spanish. Studies were excluded if they did not report sensitivity or specificity values, or any other data that enabled its calculation. Two reviewers independently performed the study selection (Daniel Ferreira and Amado Rivero-Santana), and in case of doubt and/or disagreements a third reviewer was consulted (Lilisbeth Perestelo-Pérez). The search yielded 1308 references after discarding duplicates. One-hundred fifty-eight articles were selected by title and abstract. After applying eligibility criteria, 12 articles were eventually included (Hampel et al., 2004; Herukka et al., 2005; Parnetti et al., 2006, 2012; Eckerström et al., 2010; Hertze et al., 2010; Monge-Argilés et al., 2011; Buchhave et al., 2012; Ewers et al., 2012; Gaser et al., 2013; Toledo et al., 2013; Vos et al., 2013). Three of these studies included data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). As these studies represent different analyses of overlapping ADNI subsamples, only one ADNI study was included for each meta-analysis depending on the analyzed biomarker. If two ADNI studies were available for the same biomarker, the one with largest sample was selected. Selection flow including reasons for study exclusion at each phase is shown in Figure 1.

Bottom Line: By considering several confounding factors we aimed to identify in which situations these CSF biomarkers can be useful.The p-tau had high capacity to identify MCI cases converting to AD in ≤24 months.Explaining how different confounding factors influence CSF biomarkers' predictive performance is mandatory to elaborate a definitive map of situations, where these CSF biomarkers are useful both in clinics and research.

View Article: PubMed Central - PubMed

Affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden.

ABSTRACT

Background: Cerebrospinal fluid (CSF) biomarkers' performance for predicting conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) is still suboptimal.

Objective: By considering several confounding factors we aimed to identify in which situations these CSF biomarkers can be useful.

Data sources: A systematic review was conducted on MEDLINE, PreMedline, EMBASE, PsycInfo, CINAHL, Cochrane, and CRD (1990-2013).

Eligibility criteria: (1) Prospective studies of CSF biomarkers' performance for predicting conversion from MCI to AD/dementia; (2) inclusion of Aβ42 and T-tau and/or p-tau. Several meta-analyses were performed.

Results: Aβ42/p-tau ratio had high capacity to predict conversion to AD in MCI patients younger than 70 years. The p-tau had high capacity to identify MCI cases converting to AD in ≤24 months.

Conclusions: Explaining how different confounding factors influence CSF biomarkers' predictive performance is mandatory to elaborate a definitive map of situations, where these CSF biomarkers are useful both in clinics and research.

No MeSH data available.


Related in: MedlinePlus