title: The axonal damage marker tau protein in the cerebrospinal fluid is increased in patients with acute encephalopathy with biphasic seizures and late reduced diffusion.
abstract: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a recently clinicoradiologically-established encephalopathy syndrome. In the present study, we examined the levels of cerebrospinal fluid (CSF) tau protein, a marker of axonal damage, in 11 patients with AESD. CSF tau levels were normal on day 1 and increased from day 3 of the disease between the initial and the secondary seizures. Magnetic resonance imaging (MRI) reveals reduced diffusion in the subcortical white matter during days 3-7. Two patients showed elevated tau protein prior to the diffusion abnormality of subcortical white matter on MRI. Levels of CSF neuron specific enolase (NSE), a neuronal marker, were elevated in only two out of seven patients with AESD, and CSF tau levels were also increased in these patients. Our results indicated that tau protein is a more sensitive marker than NSE and axonal damage causes the conspicuous MRI findings in AESD patients. A therapeutic strategy for axonal protection should be developed to prevent severe neurological impairment of AESD patients.
authors.affiliation: Department of Pediatrics, Tokyo Metropolitan Fuchu Medical Center for the Disabled, Fuchu, Tokyo 183-0042, Japan. Naoyuki_Tanuma@member.metro.tokyo.jp
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Tanuma
authors.forename: Rie
authors.initials: R
authors.lastname: Miyata
authors.forename: Satoko
authors.initials: S
authors.lastname: Kumada
authors.forename: Masaya
authors.initials: M
authors.lastname: Kubota
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Takanashi
authors.forename: Akihisa
authors.initials: A
authors.lastname: Okumura
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Hamano
authors.forename: Masaharu
authors.initials: M
authors.lastname: Hayashi
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D001369:Axons; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000134:cerebrospinal fluid* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004058:Diffusion; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007223:Infant; D007700:Kinetics; D008279:Magnetic Resonance Imaging; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D010751:Phosphopyruvate Hydratase / Q000134:cerebrospinal fluid; D012640:Seizures / Q000134:cerebrospinal fluid* / Q000473:pathology; D013997:Time Factors; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: C054369:MAPT protein, human; D016875:tau Proteins; D010751:Phosphopyruvate Hydratase