Comparing the clinical utility and diagnostic performance of CSF P-Tau181, P-Tau217, and P-Tau231 Assays
Open accessAbstract
BACKGROUND AND OBJECTIVES: Phosphorylated tau (p-tau) in CSF is considered an important biomarker in Alzheimer disease (AD) and has been incorporated in recent diagnostic criteria. Several variants exist, including p-tau at threonines 181 (p-tau181), 217 (p-tau217), and 231 (p-tau231). However, no studies have compared their diagnostic performance or association to β-amyloid (Aβ) and tau-PET. Understanding which p-tau variant to use remains an important yet answered question. We aimed to compare the diagnostic accuracy of p-tau181, p-tau217, and p-tau231 in CSF for AD and their association with Aβ and tau-PET. METHODS: ) and p-tau231, we also included p-tau181 measurements from 2 commonly used assays (Innotest and Elecsys). RESULTS: < 0.0001). DISCUSSION: seems to be more useful than other included p-tau assays in the workup of AD. Varied results across p-tau181 assays highlights the importance of anti-tau antibodies for biomarker performance. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that p-tau217 provides higher diagnostic accuracy for diagnosis of AD dementia than p-tau181 or p-tau231.
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CSF p-tau217 might better discriminate AD from other neurodegenerative diseases than CSF p-tau181.
“Recent reports have suggested that CSF p-tau217 might better discriminate AD from other neurodegenerative diseases24,27, 28, 29, 30 than CSF p-tau181.”
From Cerebrospinal fluid p-tau231 as an early indicator of emerging pathology in Alzheimer's disease (2022) · cites this paper as [30]
CSF p-tau217 correlates better with Aβ and tau PET imaging than CSF p-tau181.
“In addition, CSF p-tau217 correlates better with Aβ and tau PET imaging than CSF p-tau181.24,30”
From Cerebrospinal fluid p-tau231 as an early indicator of emerging pathology in Alzheimer's disease (2022) · cites this paper as [30]
No statistical superiority was demonstrated for p-tau217 over p-tau231, but higher fold changes between AD and all other clinical groups were observed for p-tau217.
“While no statistical superiority was demonstrated for p-tau217 over p-tau231, we did observe higher fold changes between AD and all other clinical groups for p-tau217 which is consistent with more recent findings.30”
From Cerebrospinal fluid p-tau231 as an early indicator of emerging pathology in Alzheimer's disease (2022) · cites this paper as [30]
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- Authors
- Leuzy, A., Janelidze, S., Mattsson-Carlgren, N., Palmqvist, S., Jacobs, D., Cicognola, C., Stomrud, E., Vanmechelen, E., Dage, J. L., & Hansson, O.
- Affiliations
- Eli Lilly (United States) (US)
- From the Clinical Memory Research Unit (A.L., S.J., N.M.-C., S.P., C.C., E.S., O.H.), Department of Clinical Sciences, Lund University, Malmö; Department of Neurology (N.M.-C.) and Memory Clinic (S.P., E.S., O.H.), Skåne University Hospital, Lund; Wallenberg Centre for Molecular Medicine (N.M.-C.), Lund University, Sweden; ADx NeuroSciences NV (D.J., E.V.), Ghent, Belgium; and Eli Lilly and Company (J.L.D.), Indianapolis, IN.
- Corresponding author
- Leuzy, Antoine
- Hansson, Oskar
- ORCID
- Venue
- Neurology
- Published
- 2021-10-26
- Volume
- 97
- Issue
- 17
- Pages
- e1681-e1694
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC8605616
- OpenAlex
- W3198098012
- Cited by
- 128
- References
- 16
- Citations by year
- 2026: 21 · 2025: 25 · 2024: 28 · 2023: 24 · 2022: 28 · 2021: 2
- FWCI
- 14.71
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Neurology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- IUScholarWorks (Indiana University) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
- Keywords
- phosphorylated tau, p-tau181, p-tau217, p-tau231, cerebrospinal fluid biomarkers, Alzheimer's disease, diagnostic accuracy, anti-tau antibodies, amyloid-beta, tau PET, Elecsys, dementia diagnosis
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Female, Humans, Immunoassay, Male, Middle Aged, Sensitivity and Specificity, Sweden, Biomarkers, tau Proteins, Protein Isoforms
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