Phosphorylated tau231 (P-tau231)
Thought to reflect build-up of neurofibrillary tangles. P-tau231 levels are elevated in patients with AD. Elevated levels are also associated with memory decline cand medial temporal atrophy in a preclinical phase. P-tau231 has also been found to be better at differentiating healthy controls from AD than p-tau181.
Invasive lumbar puncture, discomfort, recovery time in clinic to decrease risk of spinal fluid leakage
physican who can preform a lumbar puncture as well as a clinic designed for this testing, equipped lab (e.g., centrifuge), a way to measure the peptide (e.g.,mass spectrometer, protein assay kit, ELISA, or western blot)
Many groups, see 3 cited papers from NY, Sweden and UK
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Glodzik, L., de Santi, S., Tsui, W. H., Mosconi, L., Zinkowski, R., Pirraglia, E., ... & Blennow, K. (2011). Phosphorylated tau 231, memory decline and medial temporal atrophy in normal elders. Neurobiology of Aging, 32(12), 2131-2141. https://www.ncbi.nlm.nih.gov/pubmed/20133017
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Öhrfelt, A., Johansson, P., Wallin, A., Andreasson, U., Zetterberg, H., Blennow, K., & Svensson, J. (2016). Increased cerebrospinal fluid levels of ubiquitin carboxyl-terminal hydrolase L1 in patients with Alzheimer's disease. Dementia and Geriatric Cognitive Disorders Extra, 6(2), 283-294. https://www.ncbi.nlm.nih.gov/pubmed/27504117
- Spiegel, J., Pirraglia, E., Osorio, R. S., Glodzik, L., Li, Y., Tsui, W., ... & Zinkowski, R. P. (2016). Greater specificity for cerebrospinal fluid P-tau231 over P-tau181 in the differentiation of healthy controls from Alzheimer’s disease. Journal of Alzheimer's Disease, 49(1), 93-100. https://www.ncbi.nlm.nih.gov/pubmed/26444757