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Magnetic Resonance Spectroscopy and Measurement of Tau Epitopes of Autopsy Proven Sporadic Creutzfeldt-Jakob Disease in a Patient with Non-Specific Initial EEG, MRI and Negative 14-3-3 Immunoblot
Helena Šarac
Sanja Hajnšek
Silvio Bašić
Neven Henigsberg
Marko Radoš
Goran Šimić
Abstract
Limited potential of electroencephalogram (EEG), magnetic resonance images (MRI) and cerebrospinal fluid (CSF)
test for 14-3-3 protein in the clinical diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD) resulted in developments in
diagnostic premortem tehniques. Recent studies provided evidence that magnetic resonance spectroscopy (MRS) and
measurement of total- tau (T-tau) and phospho-tau (P-tau) may be useful to identify patients with CJD. We combined detected
metabolic changes in the brain by MRS and measured T-tau and tau-pT181 by ELISA, and tau-pT231 by Westernblot
in a patient with autopsy proven sCJD. Our results show that in contrast to negative CSF 14-3-3 protein, nonspecific
EEG and MRI, MRS revealed metabolic alterations in regions of the brain that has appeared normal on MRI,
and tau tests has shown measurable levels of phosphorylated and non-phosphorylated isoforms in CSF. We conclude that
rapidly progressive dementia with negative 14-3-3 test and non-specific initial EEG and MRI must still be considered in
the differential diagnosis of the sCJD. Combination of serial functional MRI along with MRS study and measurement of
tau ratio could improve the early diagnosis of sCJD. The current case is the first attempt to study results of the use of
MRS and tau tests in a case of sCJD with diagnostic dilemma.
Keywords
sporadic Creutzfeldt-Jakob disease; magnetic resonance spectroscopy; tau-protein test
Hrčak ID:
24466
URI
Publication date:
13.5.2008.
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