Urakami K, Wada K, Arai H, Sasaki H, Kanai M, Shoji M, Ishizu H, Kashihara K, Yamamoto M, Tsuchiya-Ikemoto K, Morimatsu M, Takashima H, Nakagawa M, Kurokawa K, Maruyama H, Kaseda Y, Nakamura S, Hasegawa K, Oono H, Hikasa C, Ikeda K, Yamagata K, Wakutani Y, Takeshima T, Nakashima K
Division of Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Nishimachi 36-1, 683-8504, Yonago, Japan.
J Neurol Sci. 2001 Jan 15;183(1):95-8. doi: 10.1016/s0022-510x(00)00480-9.
Distinguishing corticobasal degeneration (CBD) from progressive supranuclear palsy (PSP) is clinically and pathologically difficult, and a useful biological marker to discriminative these two diseases has been a subject of clinical interest. In the present study, we assessed tau protein levels in cerebrospinal fluids by sandwich ELISA to distinguish CBD from PSP. The subjects consisted of 27 cases of CBD, 30 cases of PSP, and 36 healthy controls (CTL). The tau values in CBD were significantly higher than those in PSP (P<0.001) and those in CTL (P<0.001). The assay of CSF tau provided diagnostic sensitivity of 81.5% and specificity of 80.0% between CBD and PSP according to receiver-operating characteristic (ROC) curve analysis. When values were compared separately with respect to stage of the disease, differences in the values for moderate CBD vs. moderate PSP had the greatest significance (P<0.001 sensitivity 92.3%, specificity 100.0%), followed by cases of mild CBD and PSP (P<0.005, sensitivity 100.0%, specificity 87.5%). The values in severe CBD and PSP were not significantly different (P=0.07, sensitivity 100%, specificity 75.0%). Using data obtained from a larger number of disease cases, we confirmed our previous findings that tau protein levels in cerebrospinal fluids in patients with CBD are significantly higher than those in patients with PSP. Because tau protein levels in cerebrospinal fluids are significantly higher in early CBD cases than in early PSP cases, measurement of tau protein levels in cerberospinal fluids may be useful for the differential diagnosis of early CBD from early PSP.
在临床和病理上，区分皮质基底节变性（CBD）和进行性核上性麻痹（PSP）都很困难，而用于鉴别这两种疾病的有效生物学标志物一直是临床关注的课题。在本研究中，我们通过夹心酶联免疫吸附测定法评估脑脊液中的tau蛋白水平，以区分CBD和PSP。研究对象包括27例CBD患者、30例PSP患者和36名健康对照者（CTL）。CBD患者的tau值显著高于PSP患者（P<0.001）和CTL（P<0.001）。根据受试者工作特征（ROC）曲线分析，脑脊液tau检测在CBD和PSP之间的诊断敏感性为81.5%，特异性为80.0%。当分别根据疾病阶段比较数值时，中度CBD与中度PSP的数值差异最为显著（P<0.001，敏感性92.3%，特异性100.0%），其次是轻度CBD和PSP病例（P<0.005，敏感性100.0%，特异性87.5%）。重度CBD和PSP的数值无显著差异（P=0.07，敏感性100%，特异性75.0%）。通过大量病例获得的数据，我们证实了之前的发现，即CBD患者脑脊液中的tau蛋白水平显著高于PSP患者。由于早期CBD病例脑脊液中的tau蛋白水平显著高于早期PSP病例，因此检测脑脊液中的tau蛋白水平可能有助于早期CBD与早期PSP的鉴别诊断。
