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Cerebrospinal Fluid Markers in Sporadic Creutzfeldt-Jakob Disease
Section of Neuropathology, Department of Neurological, Neuropsychological, Morphological and Motor Sciences, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Section of Clinical Neurology, Department of Neurological, Neuropsychological, Morphological and Motor Sciences, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 10, 37134 Verona, Italy
Section of Neurology, Department of Neurosciences, University of Padova, Via Giustiniani 5, 35128 Padova, Italy
Section of Legal Medicine, Department of Health Care Direction, San Bortolo General Hospital, Via Rodolfi 37, 36100 Vicenza, Italy
* Authors to whom correspondence should be addressed.
Received: 24 August 2011; in revised form: 16 September 2011 / Accepted: 20 September 2011 / Published: 23 September 2011
Abstract: Sporadic Creutzfeldt-Jakob disease (sCJD) is the commonest form of human prion diseases, accounting for about 85% of all cases. Current criteria for intra vitam diagnosis include a distinct phenotype, periodic sharp and slow-wave complexes at electroencephalography (EEG), and a positive 14-3-3-protein assay in the cerebrospinal fluid (CSF). In sCJD, the disease phenotype may vary, depending upon the genotype at codon 129 of the prion protein gene (PRNP), a site of a common methionine/valine polymorphism, and two distinct conformers of the pathological prion protein. Based on the combination of these molecular determinants, six different sCJD subtypes are recognized, each with distinctive clinical and pathologic phenotypes. We analyzed CSF samples from 127 subjects with definite sCJD to assess the diagnostic value of 14-3-3 protein, total tau protein, phosphorylated181 tau, and amyloid beta (Aβ) peptide 1-42, either alone or in combination. While the 14-3-3 assay and tau protein levels were the most sensitive indicators of sCJD, the highest sensitivity, specificity and positive predictive value were obtained when all the above markers were combined. The latter approach also allowed a reliable differential diagnosis with other neurodegenerative dementias.
Keywords: sporadic Creutzfeldt-Jakob disease; 14-3-3 protein; tau protein; amyloid beta peptide
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Zanusso, G.; Fiorini, M.; Ferrari, S.; Gajofatto, A.; Cagnin, A.; Galassi, A.; Richelli, S.; Monaco, S. Cerebrospinal Fluid Markers in Sporadic Creutzfeldt-Jakob Disease. Int. J. Mol. Sci. 2011, 12, 6281-6292.
Zanusso G, Fiorini M, Ferrari S, Gajofatto A, Cagnin A, Galassi A, Richelli S, Monaco S. Cerebrospinal Fluid Markers in Sporadic Creutzfeldt-Jakob Disease. International Journal of Molecular Sciences. 2011; 12(9):6281-6292.
Zanusso, Gianluigi; Fiorini, Michele; Ferrari, Sergio; Gajofatto, Alberto; Cagnin, Annachiara; Galassi, Andrea; Richelli, Silvia; Monaco, Salvatore. 2011. "Cerebrospinal Fluid Markers in Sporadic Creutzfeldt-Jakob Disease." Int. J. Mol. Sci. 12, no. 9: 6281-6292.