{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T23:23:35Z","timestamp":1794007415650,"version":"4.8.0"},"reference-count":52,"publisher":"BMJ","issue":"10","funder":[{"name":"Thierry Latran Foundation","award":["D.2468"],"award-info":[{"award-number":["D.2468"]}]},{"name":"Boehringer Ingelheim Ulm University BioCenter","award":["D.5009"],"award-info":[{"award-number":["D.5009"]}]},{"name":"EU Moodmarker programme","award":["01EW2008"],"award-info":[{"award-number":["01EW2008"]}]},{"name":"FederalMinistry of Education and Research","award":["01GI1007A"],"award-info":[{"award-number":["01GI1007A"]}]},{"name":"German Research Foundation\/DFG","award":["D.3830"],"award-info":[{"award-number":["D.3830"]}]},{"name":"German Research Foundation\/DFG","award":["SFB1279"],"award-info":[{"award-number":["SFB1279"]}]},{"name":"The foundation of the state Baden-W\u00fcrttemberg","award":["D.3830"],"award-info":[{"award-number":["D.3830"]}]},{"name":"EU Joint Programme-Neurodegenerative Diseases","award":["01ED2008A"],"award-info":[{"award-number":["01ED2008A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Synaptosomal-associated protein 25 (SNAP-25) in cerebrospinal fluid (CSF) is an emerging synaptic biomarker for the early diagnosis of Alzheimer\u2019s disease (AD). However, comprehensive studies investigating the marker in Creutzfeldt-Jakob disease (CJD) and in the differential diagnosis of neurodegenerative diseases are still lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We developed a novel, sensitive ELISA for the measurement of SNAP-25 in CSF. In total, we analysed 316 patients from 6 diagnostic groups comprising patients with AD (n=96), CJD (n=55), Parkinson\u2019s disease spectrum (n=41), frontotemporal lobar degeneration (n=25) and amyotrophic lateral sclerosis (n=24) and non-neurodegenerative control patients (n=75). Using receiver operating characteristic curve analysis, we analysed the differential diagnostic potential and compared the results with core AD biomarkers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SNAP-25 CSF concentrations were elevated in AD and CJD (p&lt;0.0001) but not in the other neurodegenerative diseases. Increased levels were observed already at early AD and CJD stages (p&lt;0.0001). In CJD, SNAP-25 levels correlated negatively with survival time (r=\u22120.33 (95% CI \u22120.57 to \u22120.04, p=0.02). For the discrimination of AD from all other diseases except CJD, we observed a good diagnostic performance for CSF SNAP-25 (area under the curve (AUC) 0.85) which was further improved by applying the ratio with CSF amyloid-\u03b2 1\u201342 (AUC 0.95). For CJD, we could demonstrate a strong differential diagnostic potential against all other groups including AD (AUC 0.97).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Using the novel established CSF SNAP-25 ELISA, we here demonstrate the applicability of SNAP-25 as an early synaptic biomarker for both AD and CJD with a possible prognostic value in patients with CJD.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnnp-2021-328646","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T17:22:31Z","timestamp":1661188951000},"page":"1059-1065","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":46,"title":["CSF levels of SNAP-25 are increased early in Creutzfeldt-Jakob and Alzheimer\u2019s 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