A systematic review comparing the diagnostic value of 14-3-3 protein in the cerebrospinal fluid, RT-QuIC and RT-QuIC on nasal brushing in sporadic Creutzfeldt–Jakob disease
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Sporadic Creutzfeldt–Jakob disease (sCJD) is a human prion disease that is a relatively common differential diagnosis in dementia patients. Therefore it needs a good diagnostic tool. Brain autopsy is the golden standard for the diagnosis of CJD; however, a less invasive technique is 14-3-3 protein measurement in the cerebrospinal fluid (CSF). In this systematic review, we compared the diagnostic value of the 14-3-3 protein measurement to the newer RT-QuIC test and a variant of RT-QuIC where nasal brushing is used to collect the samples.
The search via MeSH terms and quality assessment was carried out by two individual researchers.
In 14-3-3 and RT-QuIC the sensitivity was comparable, respectively, 88% and 86%. Specificity however was higher in RT-QuIC 99.5% compared to 80% in 14-3-3. Nasal brushing showed the best results with a sensitivity of 97% and a specificity of 100%.
Nasal brushing, despite being the best diagnostic tool according to the data, needs more study since there has only been a few studies regarding the technique. It is safe to say that due to the high specificity, RT-QuIC is superior to 14-3-3 testing.
KeywordsCJD Prion Nasal brushing RT-QuIC 14-3-3
No financial support was offered nor accepted for this systematic review.
Compliance with ethical standards
Conflict of interest
A possible conflict of interest is that one of the authors is now editor-in-chief of this journal (Patrick Cras, PhD, MD).
This article does not contain any studies with human participants or animals performed by any of the authors.
An informed consent was not needed here, as this is a systematic review.
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