Influence of timing on CSF tests value for Creutzfeldt-Jakob disease diagnosis
Male
0301 basic medicine
Time Factors
EMC NIHES-01-64-02
International Cooperation
Clinical Neurology
tau Proteins
S100 Calcium Binding Protein beta Subunit
Creutzfeldt-Jakob Syndrome
Statistics, Nonparametric
03 medical and health sciences
0302 clinical medicine
Humans
Nerve Growth Factors
Age of Onset
Aged
Retrospective Studies
Original Communication
S100 Proteins
Middle Aged
3. Good health
Europe
Neurology
14-3-3 Proteins
Phosphopyruvate Hydratase
Disease Progression
Female
DOI:
10.1007/s00415-006-0472-9
Publication Date:
2007-03-24T13:51:43Z
AUTHORS (19)
ABSTRACT
The analysis of markers in the cerebrospinal fluid (CSF) is useful in the diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD). However, the time at which the study of these markers is most sensitive remains controversal.To assess the influence of time of sampling on the value of CSF tests in the diagnosis of sCJD.In the framework of a multinational European study, we studied the results of 14-3-3, S100b, neurone specific enolase (NSE) and tau protein in 833 CSF samples from sCJD patients at different stages of disease and in 66 sequentially repeated lumbar punctures (LP).14-3-3 and tau protein tended to increase in sensitivity from onset (88%, 81%) to the advanced stage (91%, 90%). This was significant only in the methionine-valine (MV) heterozygous group of patients at codon 129. The absolute levels of S100b (p < 0.05), NSE and tau protein increased in the last stage of disease. High levels of tau protein, NSE and S100b were associated with shorter survival times (p < 0.01). Sixty-six sCJD patients underwent repeated LP. These sCJD patients were younger, had longer disease durations and were more frequently MV at codon 129 (p < 0.001) than the whole group. 14-3-3 sensitivity increased from 64% to 82% in the second LP (p = 0.025) and 88% sCJD patients had at least one positive result.Sensitivity and absolute levels of CJD markers increased with disease progression and were modulated by the codon 129 genotype. Early negative results should be inter-preted with caution, especially in young patients or those who are MV at codon 129.
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