Abstract
BACKGROUND
The diagnostic and prognostic performance of the novel fluid biomarkers brain-derived tau (BD-tau) and phospho-tau217 (p-tau217) in Creutzfeldt–Jakob disease (CJD) is not defined.
METHODS
We measured cerebrospinal fluid (CSF) and plasma BD-tau, p-tau217, p-tau181, total tau (t-tau), neurofilament light (NfL), and 14-3-3 in 100 CJD patients, 100 with non-prion rapidly progressive dementia (np-RPD), 92 with mild cognitive impairment due to Alzheimer’s disease (AD-MCI), and 55 healthy controls (HC).
RESULTS
Plasma BD-tau performed comparably to plasma t-tau but had lower performance than CSF t-tau (p < 0.001) and 14-3-3 (p = 0.014) in CJD versus np-RPD differential diagnosis. Plasma BD-tau diagnostic accuracy increased when ratioed to plasma p-tau217, matching CSF 14-3-3. Plasma BD-tau levels were associated with survival (p < 0.001), outperforming t-tau and NfL.
DISCUSSION
Plasma BD-tau is a valuable marker for CJD prognostication. In the clinical setting, the plasma BD-tau/p-tau217 ratio provides an accurate, fast marker supporting the clinical diagnosis of CJD.
Highlights
The increase of plasma BD-tau levels parallels that of CSF t-tau in CJD.
CSF p-tau217 levels are significantly increased in CJD, reflecting a prion-specific secondary tauopathy.
Plasma p-tau217 shows a distinct profile than CSF p-tau217 in CJD.
Plasma BD-tau/p-tau217 ratio is as accurate as CSF 14-3-3 in distinguishing CJD from np-RPDs, including AD.
BD-tau represents a valuable blood-based biomarker for CJD prognostication.
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This post is Copyright: Giuseppe Mario Bentivenga,
Fernando Gonzalez‐Ortiz,
Simone Baiardi,
Bjørn‐Eivind Kirsebom,
Andrea Mastrangelo,
Angela Mammana,
Sabina Capellari,
Tormod Fladby,
Henrik Zetterberg,
Kaj Blennow,
Piero Parchi | December 6, 2024