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CSF biomarkers in delirium: a systematic review
Roanna J Hall1,2, Leiv Otto Watne3,4, Emma Cunningham5
1Edinburgh Delirium Research Group, Geriatric Medicine, University of Edinburgh, Edinburgh, UK.
International Journal of Geriatric Psychiatry
|June 7, 2017
Summary
Cerebrospinal fluid (CSF) studies in delirium show biomarker evidence of Alzheimer's disease pathology and neuroinflammation are linked to the vulnerable brain, though more research is needed.
Area of Science:
- Neurology
- Biochemistry
- Geriatrics
Background:
- Delirium pathophysiology is increasingly studied using cerebrospinal fluid (CSF).
- A systematic review was conducted to synthesize current research on CSF biomarkers in delirium.
Purpose of the Study:
- To systematically review the literature on CSF studies in delirium.
- To summarize implications for understanding delirium pathophysiology.
- To discuss methods, challenges, and future directions for CSF analysis in delirium research.
Main Methods:
- Systematic search of multiple databases (MEDLINE, EMBASE, PsycINFO, Web of Science, PubMed, Cochrane Library) up to September 2016.
- Inclusion of studies using standardized delirium diagnostic criteria.
- Exclusion of case reports, with no other restrictions on study type.
Main Results:
- 22 articles were included from 3280 initial records.
- Studies involved over 400 patients with delirium and 700 controls.
- More than 70 different biomarkers were investigated, but heterogeneity precluded meta-analysis.
Conclusions:
- The literature supports the "vulnerable brain" concept in delirium.
- Biomarker evidence of Alzheimer's disease pathology and/or neuroinflammation is associated with delirium.
- Few firm conclusions can be drawn due to study heterogeneity and quality variations.
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