Alzheimer's disease biomarker utilization at first referral enhances differential diagnostic precision with simultaneous exclusion of Creutzfeldt-Jakob disease.

Autor: Wang Z; National Dementia Diagnostics Laboratory (NDDL), The Florey Institute The University of Melbourne Parkville Australia.; Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR), The Florey Institute The University of Melbourne Parkville Australia., Lewis V; Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR), The Florey Institute The University of Melbourne Parkville Australia.; Department of Medicine, Clinical Sciences Building, Royal Melbourne Hospital (RMH) The University of Melbourne Parkville Australia., Stehmann C; Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR), The Florey Institute The University of Melbourne Parkville Australia., Varghese S; National Dementia Diagnostics Laboratory (NDDL), The Florey Institute The University of Melbourne Parkville Australia., Senesi M; Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR), The Florey Institute The University of Melbourne Parkville Australia.; Department of Medicine, Clinical Sciences Building, Royal Melbourne Hospital (RMH) The University of Melbourne Parkville Australia., McGlade A; Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR), The Florey Institute The University of Melbourne Parkville Australia., Ellett LJ; Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR), The Florey Institute The University of Melbourne Parkville Australia., Doecke JD; Australian e-Health Research Centre CSIRO Parkville Australia., Eratne D; National Dementia Diagnostics Laboratory (NDDL), The Florey Institute The University of Melbourne Parkville Australia.; Neuropsychiatry, John Cade Building Royal Melbourne Hospital Parkville Australia., Velakoulis D; Neuropsychiatry, John Cade Building Royal Melbourne Hospital Parkville Australia., Masters CL; National Dementia Diagnostics Laboratory (NDDL), The Florey Institute The University of Melbourne Parkville Australia.; Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR), The Florey Institute The University of Melbourne Parkville Australia., Collins SJ; National Dementia Diagnostics Laboratory (NDDL), The Florey Institute The University of Melbourne Parkville Australia.; Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR), The Florey Institute The University of Melbourne Parkville Australia.; Department of Medicine, Clinical Sciences Building, Royal Melbourne Hospital (RMH) The University of Melbourne Parkville Australia., Li QX; National Dementia Diagnostics Laboratory (NDDL), The Florey Institute The University of Melbourne Parkville Australia.
Jazyk: angličtina
Zdroj: Alzheimer's & dementia (Amsterdam, Netherlands) [Alzheimers Dement (Amst)] 2024 Feb 13; Vol. 16 (1), pp. e12548. Date of Electronic Publication: 2024 Feb 13 (Print Publication: 2024).
DOI: 10.1002/dad2.12548
Abstrakt: Most suspected Creutzfeldt-Jakob disease (CJD) cases are eventually diagnosed with other disorders. We assessed the utility of investigating Alzheimer's disease (AD) biomarkers and neurofilament light (NfL) in patients when CJD is suspected. The study cohort consisted of cerebrospinal fluid (CSF) samples referred for CJD biomarker screening wherein amyloid beta 1-42 (Aβ1-42), phosphorylated tau 181 (p-tau181), and total tau (t-tau) could be assessed via Elecsys immunoassays ( n  = 419) and NfL via enzyme-linked immunosorbent assay (ELISA; n  = 161). In the non-CJD sub cohort ( n  = 371), 59% (219/371) had A+T- (abnormal Aβ1-42 only) and 21% (79/371) returned A+T+ (abnormal Aβ1-42 and p-tau181). In the 48 CJD subjects, a similar AD biomarker profile distribution was observed. To partially address the prevalence of likely pre-symptomatic AD, NfL was utilized to assess for neuronal damage. NfL was abnormal in 76% (25/33) of A+T- subjects 40 to 69 years of age, 80% (20/25) of whom had normal t-tau. This study reinforces AD as an important differential diagnosis of suspected CJD, highlighting that incorporating AD biomarkers and NfL at initial testing is worthwhile.
Competing Interests: The authors of no conflicts of interest to report.
(© 2024 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.)
Databáze: MEDLINE
Externí odkaz: