Zerr I et al. 2021, Diagnostic and prognostic value of plasma neurofilament light and total-tau in sporadic Creutzfeldt-Jakob disease (Alzheimers Res Ther 13:86, PMID 33883011, doi 10.1186/s13195-021-00815-6)

Open-access paper from the German national TSE reference centre in Gottingen with Spanish and Swedish partners. It measured plasma neurofilament light (NfL) and total tau (t-tau) on an ultrasensitive platform in a 309-sample cohort and found both markedly raised in sporadic CJD, with t-tau the more CJD-specific and also linked to disease duration. It is the main single-study evidence for blood-based, non-prion-protein markers of CJD in the atlas. The authors state the cutoffs need external validation before clinical use.

Key facts

  • Published 21 April 2021 in Alzheimer's Research & Therapy, volume 13, article 86, open access under CC BY; received 29 September 2020, accepted 23 March 2021.
  • Ten authors led by Inga Zerr (Gottingen) with Franc Llorens (IDIBELL and CIBERNED), and Gothenburg and UCL co-authors including Zetterberg and Blennow.
  • Cohort: 309 plasma samples, including 83 CJD cases (15 probable, 68 definite) and 70 healthy blood-donor controls, plus Alzheimer, Lewy body, frontotemporal, vascular and other neurological groups. Cases came from the German TSE reference centre biobank.
  • CJD had the highest plasma levels, about 38-fold for NfL and 18-fold for t-tau versus controls; both markers separated CJD from non-CJD dementias with AUC 0.93.
  • Cutoffs reported: NfL 70 pg/mL gave 79 percent sensitivity and 96 percent specificity versus non-CJD dementias; t-tau about 6 pg/mL gave 95 percent sensitivity and 84 percent specificity. Measured on the Quanterix Simoa HD-1.
  • Plasma t-tau, but not NfL, related to PRNP codon 129 genotype, subtype and disease duration, and gave moderate survival prediction.
  • Plasma and CSF values correlated, and diagnostic accuracy was similar (plasma t-tau AUC 0.93 versus CSF 0.97).
  • Stated limits: no serial samples, no external validation cohort, retrospective selection, and blood drawn up to 15 days after CSF in some cases.
  • Funded by multiple public and charitable sources including the Robert Koch Institute, Instituto de Salud Carlos III and the European Research Council; two authors declare industry biomarker ties.

Timeline

  1. 2020Manuscript received by the journal.
  2. 2021Accepted.
  3. 2021Published online.

People

Last checked 1 November 2026

Sources for this page