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Lee SM, Hyeon JW, Kim SJ, Kim H, Noh R, Kim S, Lee YS, Kim SY. Sensitivity and specificity evaluation of multiple neurodegenerative proteins for Creutzfeldt-Jakob disease diagnosis using a deep-learning approach. Prion 2020; 13:141-150. [PMID: 31306078 PMCID: PMC6650195 DOI: 10.1080/19336896.2019.1639482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD) can only be confirmed by abnormal protease-resistant prion protein accumulation in post-mortem brain tissue. The relationships between sCJD and cerebrospinal fluid (CSF) proteins such as 14–3-3, tau, and α-synuclein (a-syn) have been investigated for their potential value in pre-mortem diagnosis. Recently, deep-learning (DL) methods have attracted attention in neurodegenerative disease research. We established DL-aided pre-mortem diagnostic methods for CJD using multiple CSF biomarkers to improve their discriminatory sensitivity and specificity. Enzyme-linked immunosorbent assays were performed on phospho-tau (p-tau), total-tau (t-tau), a-syn, and β-amyloid (1–42), and western blot analysis was performed for 14–3-3 protein from CSF samples of 49 sCJD and 256 non-CJD Korean patients, respectively. The deep neural network structure comprised one input, five hidden, and one output layers, with 20, 40, 30, 20 and 12 hidden unit numbers per hidden layer, respectively. The best performing DL model demonstrated 90.38% accuracy, 83.33% sensitivity, and 92.5% specificity for the three-protein combination of t-tau, p-tau, and a-syn, and all other patients in a separate CSF set (n = 15) with other neuronal diseases were correctly predicted to not have CJD. Thus, DL-aided pre-mortem diagnosis may provide a suitable tool for discriminating CJD patients from non-CJD patients.
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Affiliation(s)
- Sol Moe Lee
- a Division of Bacterial Disease Research, Center for Infectious Diseases Research , Korea National Institute of Health, Centers for Disease Control and Prevention , Cheongju-si , Chungcheongbuk-do , South Korea.,b Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences , Seoul National University , Seoul , South Korea
| | - Jae Wook Hyeon
- a Division of Bacterial Disease Research, Center for Infectious Diseases Research , Korea National Institute of Health, Centers for Disease Control and Prevention , Cheongju-si , Chungcheongbuk-do , South Korea
| | - Soo-Jin Kim
- b Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences , Seoul National University , Seoul , South Korea
| | - Heebal Kim
- b Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences , Seoul National University , Seoul , South Korea
| | - Ran Noh
- a Division of Bacterial Disease Research, Center for Infectious Diseases Research , Korea National Institute of Health, Centers for Disease Control and Prevention , Cheongju-si , Chungcheongbuk-do , South Korea
| | - Seonghan Kim
- a Division of Bacterial Disease Research, Center for Infectious Diseases Research , Korea National Institute of Health, Centers for Disease Control and Prevention , Cheongju-si , Chungcheongbuk-do , South Korea
| | - Yeong Seon Lee
- a Division of Bacterial Disease Research, Center for Infectious Diseases Research , Korea National Institute of Health, Centers for Disease Control and Prevention , Cheongju-si , Chungcheongbuk-do , South Korea
| | - Su Yeon Kim
- a Division of Bacterial Disease Research, Center for Infectious Diseases Research , Korea National Institute of Health, Centers for Disease Control and Prevention , Cheongju-si , Chungcheongbuk-do , South Korea
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Oliver M, Dyke L, Rico A, Madruga M, Parellada J, Carlan SJ. Rapidly Progressing Sporadic Creutzfeldt-Jakob Disease Presenting as a Stroke. Case Rep Neurol 2018; 10:261-265. [PMID: 30323754 PMCID: PMC6180273 DOI: 10.1159/000492613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 07/31/2018] [Indexed: 01/30/2023] Open
Abstract
Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare, fatal human prion disease that is characterized by progressive dementia and neurologic degeneration. It can mimic multiple other neurological disorders, and a high index of clinical suspicion is necessary to make a diagnosis. A 74-year-old woman with a 3-month history of a stroke and progressive neurologic deterioration was found to have sCJD. She expired within a week of her diagnosis. Autopsy revealed spongiform encephalopathy consistent with prion disease, and genetic analysis revealed 129 polymorphism and no pathologic mutation, confirming the diagnosis of nonfamilial human prion disease. No pathologic evidence of a stroke was found. Awareness of the disease by clinicians is important not only at the time of initial presentation but also during the following months. Since there is no treatment, invasive medical procedures should be limited to only those that are required for either diagnosis or hospice care.
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Affiliation(s)
- Maxim Oliver
- Department of Medicine, Orlando Regional Healthcare, Orlando, Florida, USA
| | - Lisa Dyke
- Department of Medicine, Orlando Regional Healthcare, Orlando, Florida, USA
| | - Alex Rico
- Department of Medicine, Orlando Regional Healthcare, Orlando, Florida, USA
| | - Mario Madruga
- Department of Medicine, Orlando Regional Healthcare, Orlando, Florida, USA
| | - Jorge Parellada
- Department of Medicine, Orlando Regional Healthcare, Orlando, Florida, USA
| | - Steve J Carlan
- Division of Academic Affairs and Research, Orlando Regional Healthcare, Orlando, Florida, USA
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Zavadenko NN, Khondkaryan GS, Bembeeva RT, Kholin AA, Saverskaya EN. [Human prion diseases: current issues]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:88-95. [PMID: 30040808 DOI: 10.17116/jnevro20181186188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Prion diseases, or transmissible spongiform encephalopathies, are a group of neurodegenerative diseases with progressive dementia and movement disorders. There are three variants of prion diseases pathogenesis: direct contamination, genetic and sporadic forms. The following clinical forms are known: Creutzfeldt-Jakob disease (common type), variant Creutzfeldt-Jakob disease, Gerstmann-Straussler-Scheinker disease, variably protease-sensitive prionopathy, fatal insomnia and fatal familial insomnia, kuru, prion disease associated with diarrhea and autonomic neuropathy. Clinical characteristic of prion diseases, molecular-genetic aspects of their pathogenesis and current diagnostic approaches are discussed. Because of the lack of effective treatment, prevention of both alimentary prion infections (consumption of contaminated meat products) and transmissible iatrogenic infections (the use of biopreparations from animal tissues) is important. The safety of such biopreparations should be ensured by modern manufacturing technologies and specially developed procedures that meet international requirements and standards.
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Affiliation(s)
- N N Zavadenko
- Pirogov Russian National Research Medical University of the Russian Federation Ministry of Health, Moscow, Russia
| | - G Sh Khondkaryan
- Pirogov Russian National Research Medical University of the Russian Federation Ministry of Health, Moscow, Russia
| | - R Ts Bembeeva
- Pirogov Russian National Research Medical University of the Russian Federation Ministry of Health, Moscow, Russia
| | - A A Kholin
- Pirogov Russian National Research Medical University of the Russian Federation Ministry of Health, Moscow, Russia
| | - E N Saverskaya
- Institute of Medical and Social Technologies, Moscow State University of Food Production, Moscow, Russia
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Peckeu L, Delasnerie-Lauprètre N, Brandel JP, Salomon D, Sazdovitch V, Laplanche JL, Duyckaerts C, Seilhean D, Haïk S, Hauw JJ. Accuracy of diagnosis criteria in patients with suspected diagnosis of sporadic Creutzfeldt-Jakob disease and detection of 14-3-3 protein, France, 1992 to 2009. ACTA ACUST UNITED AC 2018; 22. [PMID: 29043964 PMCID: PMC5710122 DOI: 10.2807/1560-7917.es.2017.22.41.16-00715] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Diagnostic criteria of Creutzfeldt–Jakob disease (CJD), a rare and fatal transmissible nervous system disease with public health implications, are determined by clinical data, electroencephalogram (EEG), detection of 14-3-3 protein in cerebrospinal fluid (CSF), brain magnetic resonance imaging and prion protein gene examination. The specificity of protein 14-3-3 has been questioned. We reviewed data from 1,572 autopsied patients collected over an 18-year period (1992–2009) and assessed whether and how 14-3-3 detection impacted the diagnosis of sporadic CJD in France, and whether this led to the misdiagnosis of treatable disorders. 14-3-3 detection was introduced into diagnostic criteria for CJD in 1998. Diagnostic accuracy decreased from 92% for the 1992–1997 period to 85% for the 1998–2009 period. This was associated with positive detections of 14-3-3 in cases with negative EEG and alternative diagnosis at autopsy. Potentially treatable diseases were found in 163 patients (10.5%). This study confirms the usefulness of the recent modification of diagnosis criteria by the addition of the results of CSF real-time quaking-induced conversion, a method based on prion seed-induced misfolding and aggregation of recombinant prion protein substrate that has proven to be a highly specific test for diagnosis of sporadic CJD.
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Affiliation(s)
- Laurene Peckeu
- Assistance publique-Hôpitaux de Paris (AP-HP), Cellule nationale de référence des maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France.,These authors contributed equally to this study and share first authorship.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France
| | - Nicole Delasnerie-Lauprètre
- These authors contributed equally to this study and share first authorship.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Assistance publique-Hôpitaux de Paris (AP-HP), Cellule nationale de référence des maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France
| | - Jean-Philippe Brandel
- Assistance publique-Hôpitaux de Paris (AP-HP), Cellule nationale de référence des maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France
| | - Dominique Salomon
- Institut National de la Santé et de la Recherche Médicale (Inserm), Unité Mixte de Recherche (UMR) 1153, Paris, France
| | - Véronique Sazdovitch
- Assistance publique-Hôpitaux de Paris (AP-HP), Laboratoire de Neuropathologie Raymond Escourolle, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France
| | - Jean-Louis Laplanche
- Assistance publique-Hôpitaux de Paris (AP-HP), Service de Biochimie et Biologie Moléculaire, Hôpital Lariboisière; Université Paris Descartes, Paris, France
| | - Charles Duyckaerts
- Assistance publique-Hôpitaux de Paris (AP-HP), Laboratoire de Neuropathologie Raymond Escourolle, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France
| | - Danielle Seilhean
- Assistance publique-Hôpitaux de Paris (AP-HP), Laboratoire de Neuropathologie Raymond Escourolle, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France
| | - Stéphane Haïk
- Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France.,Assistance publique-Hôpitaux de Paris (AP-HP), Laboratoire de Neuropathologie Raymond Escourolle, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Assistance publique-Hôpitaux de Paris (AP-HP), Cellule nationale de référence des maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France
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