NR AVBT
AU Sanchez-Juan,P.; Green,A.; Ladogana,A.; Cuadrado Corrales,N.; Saanchez-Valle,R.; Mitrovaa,E.; Stoeck,K.; Sklaviadis,T.K.; Kulczycki,J.; Hess,K.; Bodemer,M.; Slivarichova,D.; Saiz,A.; Calero,M.; Ingrosso,L.; Knight,R.; Janssens,A.C.; van Duijn,C.M.; Zerr,I.
TI CSF tests in the differential diagnosis of Creutzfeldt-Jakob disease
QU Neurology 2006 Aug 22; 67(4): 637-43
PT controlled clinical trial; journal article; multicenter study
AB OBJECTIVES: To analyze the diagnostic sensitivity and specificity of various brain-derived proteins (14-3-3, Tau, neuron specific enolase [NSE], and S100b) in the CSF of patients with Creutzfeldt-Jakob disease (CJD) and to analyze biologic factors that modify these parameters. METHODS: CSF was tested for 14-3-3, Tau, NSE, and S100b in 1,859 patients with sporadic, genetic, iatrogenic, and variant CJD, and in 1,117 controls. RESULTS: The highest sensitivity was achieved for 14-3-3 and Tau in sporadic CJD (85% and 86%), and a combined determination of 14-3-3 and Tau, S100b, or NSE increased the sensitivity to over 93%. A multivariate analysis showed that the sensitivity of all tests was highest in patients with the shortest disease duration, age at onset >40 years, and homozygosity at codon 129 of the prion protein gene. In a group of patients with repeated lumbar punctures, a second test also increased the diagnostic sensitivity. CONCLUSIONS: The detection of elevated levels of brain-derived proteins in the CSF in patients with suspected Creutzfeldt-Jakob disease is a valuable diagnostic test. A second lumbar puncture may be of value in patients with atypical clinical course in whom the first test was negative.
MH 14-3-3 Proteins/*cerebrospinal fluid; Adolescent; Adult; Aged; Aged, 80 and over; Biological Markers/cerebrospinal fluid; Child; Child, Preschool; Creutzfeldt-Jakob Syndrome/*cerebrospinal fluid/*diagnosis/epidemiology; Diagnosis, Differential; Europe/epidemiology; Humans; Middle Aged; Nerve Tissue Proteins/*cerebrospinal fluid; Reproducibility of Results; Research Support, Non-U.S. Gov't; Sensitivity and Specificity
AD Department of Epidemiology &s Biostatistics, Erasmus University Medical Center Rotterdam, The Netherlands.
SP englisch
PO USA