Published in:
Open Access 01-07-2007 | ORIGINAL COMMUNICATION
Influence of timing on CSF tests value for Creutzfeldt-Jakob disease diagnosis
Published in: Journal of Neurology | Issue 7/2007
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Background
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.
Objective
To assess the influence of time of
sampling on the value of CSF tests
in the diagnosis of sCJD.
Method
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).
Results
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.
Conclusions
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.