Total tau protein in cerebrospinal fluid and diffusion-weighted MRI as an early diagnostic marker for Creutzfeldt-Jakob disease.
BACKGROUND
We have recently begun to doubt the effectiveness of periodic sharp wave complexes observed on electroencephalographs and the detection of 14-3-3 protein in cerebrospinal fluid (CSF) as diagnostic criteria for Creutzfeldt-Jakob disease (CJD). Diffusion-weighted magnetic resonance imaging (DWI) and the detection of total tau (t-tau) protein in CSF may be more sensitive diagnostic criteria.


METHODS
Among 44 CJD patients, we selected 21 subjects that suffered from early-stage CJD, which was defined as cases in the 6 weeks following the onset of the disease. The sensitivities of DWI and electroencephalographs, as well as those of t-tau protein, 14-3-3 protein, neuron-specific enolase (NSE), and S-100b protein in CSF were compared as diagnostic markers for early-stage CJD.


RESULTS
NSE, S-100b protein, t-tau protein, and 14-3-3 protein were detected in the samples from 57.1, 4.8, 95.2, and 76.2% of the 21 early-stage CJD patients, respectively. Additionally, DWI was used to positively identify 90.5% of these cases.


CONCLUSIONS
We concluded that t-tau protein was the most sensitive of the diagnostic markers for CJD. Moreover, the data in this study showed that detection of t-tau protein combined with DWI identified 98% of the early-stage cases, and these tests should be included as diagnostic criteria for CJD.
Satoh
Katsuya
K
First Department of Internal Medicine, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan. f1537@cc.nagasaki-u.ac.jp
Shirabe
Susumu
S
Tsujino
Akira
A
Eguchi
Hiroto
H
Motomura
Masakatsu
M
Honda
Hiroyuki
H
Tomita
Iturou
I
Satoh
Akira
A
Tsujihata
Mitsuhiro
M
Matsuo
Hidenori
H
Nakagawa
Masanori
M
Eguchi
Katsumi
K
D048948:14-3-3 Proteins / Q000134:cerebrospinal fluid; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D007562:Creutzfeldt-Jakob Syndrome / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D004569:Electroencephalography; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000134:cerebrospinal fluid; D009483:Neuropsychological Tests; D010751:Phosphopyruvate Hydratase / Q000134:cerebrospinal fluid; D011328:Prions / Q000134:cerebrospinal fluid; D015203:Reproducibility of Results; D012189:Retrospective Studies; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000134:cerebrospinal fluid; D016875:tau Proteins / Q000134:cerebrospinal fluid*
D048948:14-3-3 Proteins; D015415:Biomarkers; D009414:Nerve Growth Factors; D011328:Prions; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D016875:tau Proteins; D010751:Phosphopyruvate Hydratase