TY - JOUR
T1 - EFNS guidelines on disease-specific CSF investigations
AU - Deisenhammer, F
AU - Egg, R
AU - Giovannoni, G
AU - Hemmer, B
AU - Petzold, A
AU - Sellebjerg, F
AU - Teunissen, C
AU - Tumani, H
AU - EFSN
PY - 2009/6
Y1 - 2009/6
N2 - We reviewed the literature for disease-specific markers in cerebrospinal fluid (CSF) and evaluated their diagnostic and prognostic relevance in neurological diseases. High tau protein in combination with low amyloid beta levels has a high sensitivity (80%) and specificity (90%) for Alzheimer's disease (AD) against normal aging and can predict conversion of mild cognitive impairment to AD. The detection of 14-3-3 has a high sensitivity (80-90%) and specificity (90%) for the diagnosis of CJD. Low or undetectable CSF hypocretin-1 (orexin-1) levels constitute a diagnostic biomarker for narcolepsy with cataplexy. Detection of beta-2-transferrin indicates CSF contamination in oto- and rhinorrhoe with a sensitivity of > 79% at a specificity of 95% similar to the beta-trace protein (sensitivity > 90%, specificity 100%). However, beta-trace protein is faster and cheaper to perform. Possible future biomarkers are: elevated levels of vascular endothelial growth factor are relatively sensitive (51-100%) and specific (73-100%) for leptomeningeal metastases from solid tumors and are associated with a poor prognosis in this condition. Elevated CSF neurofilament (Nf) levels probably reflect acute neuronal degeneration. The prognostic value of CSF Nf levels is highest in acute conditions such as subarachnoid hemorrhage, acute optic neuritis and neuromyelitis optica.
AB - We reviewed the literature for disease-specific markers in cerebrospinal fluid (CSF) and evaluated their diagnostic and prognostic relevance in neurological diseases. High tau protein in combination with low amyloid beta levels has a high sensitivity (80%) and specificity (90%) for Alzheimer's disease (AD) against normal aging and can predict conversion of mild cognitive impairment to AD. The detection of 14-3-3 has a high sensitivity (80-90%) and specificity (90%) for the diagnosis of CJD. Low or undetectable CSF hypocretin-1 (orexin-1) levels constitute a diagnostic biomarker for narcolepsy with cataplexy. Detection of beta-2-transferrin indicates CSF contamination in oto- and rhinorrhoe with a sensitivity of > 79% at a specificity of 95% similar to the beta-trace protein (sensitivity > 90%, specificity 100%). However, beta-trace protein is faster and cheaper to perform. Possible future biomarkers are: elevated levels of vascular endothelial growth factor are relatively sensitive (51-100%) and specific (73-100%) for leptomeningeal metastases from solid tumors and are associated with a poor prognosis in this condition. Elevated CSF neurofilament (Nf) levels probably reflect acute neuronal degeneration. The prognostic value of CSF Nf levels is highest in acute conditions such as subarachnoid hemorrhage, acute optic neuritis and neuromyelitis optica.
KW - Alzheimer Disease/cerebrospinal fluid
KW - Biomarkers/analysis
KW - Brain Diseases/cerebrospinal fluid
KW - Cerebrospinal Fluid Proteins/analysis
KW - Creutzfeldt-Jakob Syndrome/cerebrospinal fluid
KW - Humans
KW - Meningeal Carcinomatosis/cerebrospinal fluid
KW - Narcolepsy/cerebrospinal fluid
KW - Optic Neuritis/cerebrospinal fluid
KW - Predictive Value of Tests
KW - Prognosis
KW - Subarachnoid Hemorrhage/cerebrospinal fluid
U2 - 10.1111/j.1468-1331.2009.02595.x
DO - 10.1111/j.1468-1331.2009.02595.x
M3 - Review
C2 - 19475759
SN - 1351-5101
VL - 16
SP - 760
EP - 770
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 6
ER -