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Title: Prevalence and clinical associations of tau in Lewy body dementias: A systematic review and meta-analysis.
Austin Authors: Chin, Kai Sin;Yassi, Nawaf;Churilov, Leonid ;Masters, Colin Louis;Watson, Rosie
Affiliation: The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, 3052, Australia
Department of Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, 3050, Australia
Medicine (University of Melbourne)
Department of Medicine - The Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, 3050, Australia
Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
Issue Date: 23-Sep-2020
Date: 2020-09-23
Publication information: Parkinsonism & Related Disorders 2020; 80: 184-193
Abstract: Alzheimer's disease neuropathologies (amyloid-β and tau) frequently co-exist to varying degrees in Lewy body dementias (LBD), which include dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). To investigate the prevalence of tau in DLB and PDD, and its associations with clinical outcomes. We searched the major electronic databases using the search term: ("dementia with Lewy bodies" OR "diffuse Lewy body disease" OR "Lewy body variant of Alzheimer's disease") AND ("tau protein" OR "tauopathy" OR "neurofibrillary tangle"), for relevant studies which evaluated tau in LBD. Forty-nine articles met the inclusion criteria for data extraction. Where appropriate, a random-effect meta-analysis was performed to obtain pooled estimates for prevalence and risk ratios (RR) or standardized mean differences (SMD) for clinical features, diagnostic accuracy and cognition. Braak neurofibrillary tangle stage ≥ III was observed in 66% (n = 1511, 95%CI 60%-73%) of DLB and 52% (n = 433, 95%CI 27%-76%) of PDD at autopsy. Abnormal CSF phosphorylated-tau levels were present in 28% (n = 925, 95%CI 25%-31%) of DLB and 15% (n = 172, 95%CI 5%-24%) of PDD cases. Higher tau burden in DLB was associated with reduced likelihood of manifesting visual hallucinations (RR 0.56; 95%CI 0.40-0.77) and motor parkinsonism (RR 0.62; 95%CI 0.40-0.98), lower diagnostic accuracy of DLB during life (RR 0.49; 95%CI 0.38-0.64) and worse cognition prior to death (SMD 0.63; 95%CI 0.46-0.81). Tau is common in LBD and may reduce clinical diagnostic accuracy in people with DLB. Prospective longitudinal studies are needed to understand the roles of co-morbid neuropathologies in Lewy body dementias.
DOI: 10.1016/j.parkreldis.2020.09.030
Journal: Parkinsonism & Related Disorders
PubMed URL: 33260030
Type: Journal Article
Subjects: Alzheimer's disease
Dementia with Lewy bodies
Lewy body dementia
Parkinson's disease dementia
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