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Prion Disease
Researchers from University of Bologna publish findings in prion disease
November 6th, 2009
Current study results from the report, 'Magnetic resonance diagnostic markers in clinically sporadic prion disease: a combined brain magnetic resonance imaging and spectroscopy study,' have been published. According to a study from Bologna, Italy, "The intra vitam diagnosis of prion disease is challenging and a definite diagnosis still requires neuropathological examination in non-familial cases. Magnetic resonance imaging has gained increasing importance in the diagnosis of prion disease." "The aim of this study was to compare the usefulness of different magnetic resonance imaging sequences and proton magnetic resonance spectroscopy in the differential diagnosis of patients with rapidly progressive neurological signs compatible with the clinical diagnosis of sporadic prion disease. Twenty-nine consecutive patients with an initial diagnosis of possible or probable sporadic prion disease, on the basis of clinical and electroencephalography features, were recruited. The magnetic resonance protocol included axial fluid-attenuated inversion recovery-T2-and diffusion-weighted images, and proton magnetic resonance spectroscopy of the thalamus, striatum, cerebellum and occipital cortex. Based on the clinical follow-up, genetic studies and neuropathology, the final diagnosis was of prion disease in 14 patients out of 29. The percentage of correctly diagnosed cases was 86% for diffusion-weighted imaging (hyperintensity in the striatum/cerebral cortex), 86% for thalamic N-acetyl-aspartate to creatine ratio (cutoff </=1.21), 90% for thalamic N-acetyl-aspartate to myo-inositol (mI) ratio (cutoff </=1.05) and 86% for cerebral spinal fluid 14-3-3 protein. All the prion disease patients had N-acetyl-aspartate to creatine ratios </=1.21 (100% sensitivity and 100% negative predictive value) and all the non-prion patients had N-acetyl-aspartate to myo-inositol ratios >1.05 (100% specificity and 100% positive predictive value). Univariate logistic regression analysis showed that the combination of thalamic N-acetyl-aspartate to creatine ratio and diffusion-weighted imaging correctly classified 93% of the patients. The combination of thalamic proton magnetic resonance spectroscopy (10 min acquisition duration) and brain diffusion-weighted imaging (2 min acquisition duration) may increase the diagnostic accuracy of the magnetic resonance scan," wrote R. Lodi and colleagues, University of Bologna. The researchers concluded: "Both sequences should be routinely included in the clinical work-up of patients with suspected prion disease." Lodi and colleagues published the results of their research in Brain (Magnetic resonance diagnostic markers in clinically sporadic prion disease: a combined brain magnetic resonance imaging and spectroscopy study. Brain, 2009;132(Pt 10):2669-79). For additional information, contact R. Lodi, University of Bologna, Aging and Nephrology, Dept. of Internal Medicine, Aging and Nephrology, Azienda Universitario-Ospedaliera di Bologna, Via Massarenti 9, Bologna, Italy. The publisher of the journal Brain can be contacted at: Oxford University Press, Great Clarendon St., Oxford OX2 6DP, England. Keywords: Italy, Bologna, Diagnostics, Differential Diagnosis, Genetics, Magnetic Resonance, Neuropathology, Pathology, Prion Disease, Spectroscopy, Surgery. This article was prepared by NewsRx editors from staff and other reports. Copyright 2009, NewsRx.com.
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