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CSF biomarkers in delirium: a systematic review

Hall, RJ; Watne, LO; Cunningham, E; Zetterberg, H; Shenkin, SD; Wyller, TB; MacLullich, AMJ; (2017) CSF biomarkers in delirium: a systematic review. International Journal of Geriatric Psychiatry , 33 (11) pp. 1479-1500. 10.1002/gps.4720. Green open access

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Abstract

Objective In recent years, there has been a blossoming of studies examining cerebrospinal fluid (CSF) as a method of studying the pathophysiology of delirium. We systematically reviewed the literature for CSF studies in delirium and provide here a summary of the implications for our understanding of delirium pathophysiology. We also summarise the methods used for CSF analysis and discuss challenges and implications for future studies. Methods In this systematic review, we screened MEDLINE, EMBASE, PsycINFO, Web of Science, PubMed and the Cochrane Library for articles on CSF biomarkers in delirium, published on 3 September 2016. Studies were required to use Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria for delirium or a validated tool. We excluded case reports. There were no other restrictions on study type. Results We identified 3280 articles from our initial search, and 22 articles were included in this review. All studies were prospective, including over 400 patients with delirium and 700 controls. More than 70 different biomarkers were studied. Studies could not be compared with each other for meta‐analysis because of their heterogeneity and varied widely in their risk of bias and quality assessments. Conclusions The 22 studies identified in this review reveal a small but growing literature, in which many of the important hypotheses in delirium pathogenesis have been examined, but from which few firm conclusions can currently be drawn. Nevertheless, the overall interpretation of the literature supports the vulnerable brain concept, that is, that biomarker evidence of, for example, Alzheimer's disease pathology and/or neuroinflammation, is associated with delirium.

Type: Article
Title: CSF biomarkers in delirium: a systematic review
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/gps.4720
Publisher version: https://doi.org/10.1002/gps.4720
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Geriatrics & Gerontology, Gerontology, Psychiatry, delirium pathophysiology, CSF biomarkers, neuroinflammation, HIP FRACTURE PATIENTS, POPULATION-BASED COHORT, CEREBROSPINAL-FLUID, FOLLOW-UP, COGNITIVE DECLINE, RISK-FACTOR, DEMENTIA, PROTEIN, PEOPLE, NEUROINFLAMMATION
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/10060989
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