Alzheimer's Disease vs Control: tau-p231 (CSF)


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A large number of studies over the past 20 years have quantified phosphorylated tau protein in the cerebrospinal fluid of people with Alzheimer’s disease. While the majority of assays have used antibodies targeting tau phosphorylated at threonine 181 (tau-p181), assays have been developed to measure other phospho-tau species, including tau phosphorylated at threonine 231 (tau-p231). Meta-analysis of five comparisons showed that levels of tau-p231 in the CSF of people with Alzheimer's disease were nearly six times those in control subjects (effect size = 5.893, p <0.0001). Tau-p231, in both CSF and plasma, is gaining attention as a biomarker of presymptomatic AD (Ashton et al., 2021; Suárez-Calvet et al., 2020).

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How to interpret a forest plot: Each individual effect size (ES) is a ratio of the mean biomarker level in one condition over the mean level in another condition. An ES equal to 1 means that the two conditions had identical mean values. An ES > 1 indicates higher levels in the first condition, whereas an ES < 1 indicates lower levels in the first condition. The overall ES, indicated by a black diamond, is a weighted average of the individual effect sizes. The weight of each data point was determined by the inverse of the variance and is reflected in the size of each square. The width of the overall ES diamond is determined by the 95 percent confidence interval. Data out of range of the scale, including ES and confidence intervals, are indicated by an arrowhead at the edge of the plot, when applicable. 

Version 3.0, July 2021.