title: Magnetic resonance imaging in E200K and V210I mutations of the prion protein gene.
abstract: Magnetic resonance imaging (MRI), with diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR), is a useful diagnostic investigation for Creutzfeldt-Jakob disease (CJD). Amendment of the diagnostic criteria for sporadic CJD (sCJD) to include defined MRI alterations has just recently been proposed. We analyzed MRI scans with FLAIR and/or DWI available of 29 patients with the E200K or the V210I mutation, and a control group of 29 sCJD patients to compare the MRI lesion profile and evaluate the applicability of new MRI criteria to genetic CJD patients. FLAIR images of all 29 patients and controls and DWI images of 15 genetic CJD and 13 sCJD were rated by 2 neuroradiologists blinded to diagnosis and genetic testing. In genetic CJD (gCJD) patients, hyperintensities on FLAIR could be found in the putamen in 55% and the caudate nucleus in 66% and on DWI in 33% and 60%, respectively. Lesion profile and frequency of hyperintensities did not differ significantly from the findings in sCJD. New diagnostic MRI criteria yield similar sensitivity for gCJD and sCJD, being 79% and 72%, respectively. MRI provides useful information in E200K and V210I gCJD patients. The alterations strongly resembled those seen in sCJD, once again demonstrating the similarity of the clinical syndrome in patients with these particular mutations.
authors.affiliation: Department of Neurology, National TSE Reference Center, Georg-August University Goettingen, Goettingen, Germany.
authors.forename: Maren
authors.initials: M
authors.lastname: Breithaupt
authors.forename: Carlos
authors.initials: C
authors.lastname: Romero
authors.forename: Kai
authors.initials: K
authors.lastname: Kallenberg
authors.forename: Christian
authors.initials: C
authors.lastname: Begue
authors.forename: Pascual
authors.initials: P
authors.lastname: Sanchez-Juan
authors.forename: Sabina
authors.initials: S
authors.lastname: Eigenbrod
authors.forename: Hans
authors.initials: H
authors.lastname: Kretzschmar
authors.forename: Gabi
authors.initials: G
authors.lastname: Schelzke
authors.forename: Eduardo
authors.initials: E
authors.lastname: Meichtry
authors.forename: Analia
authors.initials: A
authors.lastname: Taratuto
authors.forename: Inga
authors.initials: I
authors.lastname: Zerr
mesh_terms: D007562:Creutzfeldt-Jakob Syndrome / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011328:Prions / Q000235:genetics; D012680:Sensitivity and Specificity
chemical_list: D011328:Prions