TY  - JOUR
AU  - Schmitz, Matthias
AU  - Villar-Piqué, Anna
AU  - Hermann, Peter
AU  - Escaramís, Geòrgia
AU  - Calero, Miguel
AU  - Chen, Cao
AU  - Kruse, Niels
AU  - Cramm, Maria
AU  - Golanska, Ewa
AU  - Sikorska, Beata
AU  - Liberski, Pawel P
AU  - Pocchiari, Maurizio
AU  - Lange, Peter
AU  - Stehmann, Christiane
AU  - Sarros, Shannon
AU  - Martí, Eulàlia
AU  - Baldeiras, Inês
AU  - Santana, Isabel
AU  - Žáková, Dana
AU  - Mitrová, Eva
AU  - Dong, Xiao-Ping
AU  - Collins, Steven
AU  - Poleggi, Anna
AU  - Ladogana, Anna
AU  - Mollenhauer, Brit
AU  - Kovacs, Gabor G
AU  - Geschwind, Michael D
AU  - Sánchez-Valle, Raquel
AU  - Zerr, Inga
AU  - Llorens Torres, Francesc Josep
TI  - Diagnostic accuracy of cerebrospinal fluid biomarkers in genetic prion diseases.
JO  - Brain
VL  - 145
IS  - 2
SN  - 0006-8950
CY  - Oxford
PB  - Oxford Univ. Press
M1  - DZNE-2022-00732
SP  - 700 - 712
PY  - 2022
N1  - (CC BY-NC)
AB  - Genetic prion diseases are a rare and diverse group of fatal neurodegenerative disorders caused by pathogenic sequence variations in the prion protein gene, PRNP. Data on CSF biomarkers in patients with genetic prion diseases are limited and conflicting results have been reported for unclear reasons. Here, we aimed to analyse the diagnostic accuracy of CSF biomarkers currently used in prion clinical diagnosis in 302 symptomatic genetic prion disease cases from 11 prion diagnostic centres, encompassing a total of 36 different pathogenic sequence variations within the open reading frame of PRNP. CSF samples were assessed for the surrogate markers of neurodegeneration, 14-3-3 protein (14-3-3), total-tau protein (t-tau) and α-synuclein and for prion seeding activity through the real-time quaking-induced conversion assay. Biomarker results were compared with those obtained in healthy and neurological controls. For the most prevalent PRNP pathogenic sequence variations, biomarker accuracy and associations between biomarkers, demographic and genetic determinants were assessed. Additionally, the prognostic value of biomarkers for predicting total disease duration from symptom onset to death was investigated. High sensitivity of the four biomarkers was detected for genetic Creutzfeldt-Jakob disease associated with the E200K and V210I mutations, but low sensitivity was observed for mutations associated with Gerstmann-Sträussler-Scheinker syndrome and fatal familial insomnia. All biomarkers showed good to excellent specificity using the standard cut-offs often used for sporadic Creutzfeldt-Jakob disease. In genetic prion diseases related to octapeptide repeat insertions, the biomarker sensitivity correlated with the number of repeats. New genetic prion disease-specific cut-offs for 14-3-3, t-tau and α-synuclein were calculated. Disease duration in genetic Creutzfeldt-Jakob disease-E200K, Gerstmann-Sträussler-Scheinker-P102L and fatal familial insomnia was highly dependent on PRNP codon 129 MV polymorphism and was significantly associated with biomarker levels. In a large cohort of genetic prion diseases, the simultaneous analysis of CSF prion disease biomarkers allowed the determination of new mutation-specific cut-offs improving the discrimination of genetic prion disease cases and unveiled genetic prion disease-specific associations with disease duration.
KW  - Biomarkers: cerebrospinal fluid
KW  - Creutzfeldt-Jakob Syndrome: diagnosis
KW  - Creutzfeldt-Jakob Syndrome: genetics
KW  - Humans
KW  - Insomnia, Fatal Familial: genetics
KW  - Prion Diseases: diagnosis
KW  - Prion Diseases: genetics
KW  - Prion Proteins: genetics
KW  - Prions: genetics
KW  - alpha-Synuclein
KW  - biomarker (Other)
KW  - cerebrospinal fluid (Other)
KW  - diagnostic marker (Other)
KW  - genetic prion diseases (Other)
KW  - Biomarkers (NLM Chemicals)
KW  - Prion Proteins (NLM Chemicals)
KW  - Prions (NLM Chemicals)
KW  - alpha-Synuclein (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:35288744
C2  - pmc:PMC9014756
DO  - DOI:10.1093/brain/awab350
UR  - https://pub.dzne.de/record/164069
ER  -