A comparison of tau and 14-3-3 protein in the diagnosis of Creutzfeldt-Jakob disease

Clive Hamlin, Gianfranco Puoti, Sally Berri, Elliott Sting, Carrie Harris, Mark Cohen, Charles Spear, Alberto Bizzi, Sara M. Debanne, Douglas Y. Rowland

Research output: Contribution to journalArticlepeer-review


Objective: To compare the respective efficiency of CSF tau (quantitative) and CSF 14-3-3 protein (qualitative) in the diagnosis of prion disease. Methods: We made measurements on 420 live subjects, who subsequently underwent a postmortem neuropathology examination, including protein chemistry, immunohistochemistry, and histology. We performed tau by ELISA. We detected 14-3-3 protein by Western blot. Both assays were optimized for maximum efficiency (accuracy). Results: We found tau and 14-3-3 proteins to be closely correlated, but tau had a significantly better ability to predict disease status than 14-3-3 protein. Also, tau distinguished disease status at least as well as when both assays' results are combined in a variety of ways. Importantly, the area under the receiver operating characteristic curve for tau (0.82) was significantly larger than that for 14-3-3 protein (0.68) (p <0.001). Diagnostic test statistics are provided for the study subjects with 58.3% prevalence, and for a more typical, nonselected, 7.5% prevalence as received by our center. Conclusion: In this study, tau is superior to 14-3-3 protein as a marker in the diagnosis of Creutzfeldt- Jakob disease, and is as efficient singly compared to a variety of combinations with 14-3-3 protein. This is the first study of this magnitude to examine prion disease diagnostic tests in a carefully characterized patient population with detailed statistical evaluation.

Original languageEnglish
Pages (from-to)547-552
Number of pages6
Issue number6
Publication statusPublished - Aug 7 2012

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)


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