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Denouel A, Brandel JP, Seilhean D, Laplanche JL, Elbaz A, Haik S. The role of environmental factors on sporadic Creutzfeldt-Jakob disease mortality: evidence from an age-period-cohort analysis. Eur J Epidemiol 2023:10.1007/s10654-023-01004-5. [PMID: 37191829 DOI: 10.1007/s10654-023-01004-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023]
Abstract
Sporadic Creutzfeldt-Jakob disease (sCJD) is the most common form of prion diseases. The causes of sCJD are still unknown and exogenous factors may play a role. Worldwide, the number of patients with sCJD has progressively increased over time. This increase can be partly explained by increasing life expectancy and better case ascertainment, but a true increase in the number of sCJD cases cannot be excluded. We estimated mortality rates from sCJD in France (1992-2016) and studied variation in mortality rates by age, period, and time.We included all cases aged 45-89 years old who died with a probable/definite sCJD diagnosis based on the French national surveillance network. We used age-period-cohort (APC) Poisson regression models to study variation in mortality rates by sex, age, period, and time.A total of 2475 sCJD cases aged 45-89 years were included. Mortality rates increased with age, reached a peak between 75 and 79 years, and decreased thereafter. Mortality rates were higher in women than men at younger ages and lower at older ages. The full APC model with a sex×age interaction provided the best fit to the data, thus in favour of sex, age, period, and cohort effects on mortality rates. In particular, mortality rates increased progressively with successive birth cohorts.Based on 25 years of active surveillance in France, we show evidence for sex, age, period, and cohort effects on sCJD mortality. The identification of cohort effects suggests that environmental exposures may play a role in sCJD etiology.
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Affiliation(s)
- Angéline Denouel
- CNRS UMR 7225, INSERM U1127, Paris Brain Institute, Sorbonne Universités, Paris, France.
| | - Jean-Philippe Brandel
- CNRS UMR 7225, INSERM U1127, Paris Brain Institute, Sorbonne Universités, Paris, France
- AP-HP, Centre National de Référence des Maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Danielle Seilhean
- CNRS UMR 7225, INSERM U1127, Paris Brain Institute, Sorbonne Universités, Paris, France
| | - Jean-Louis Laplanche
- Département de Biochimie et Biologie Moléculaire, Hôpitaux Lariboisière-Fernand Widal, Paris, France
- INSERM, UMR 1144, "Optimisation Thérapeutique en Neuropsychopharmacologie", Paris, France
| | - Alexis Elbaz
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Gustave Roussy, Inserm, U1018, Team « Exposome, Heredity, Cancer, and Health », CESP, Villejuif, 94807, France
| | - Stéphane Haik
- CNRS UMR 7225, INSERM U1127, Paris Brain Institute, Sorbonne Universités, Paris, France
- AP-HP, Centre National de Référence des Maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Balash Y, Kahana E, Korczyn AD, Wolker M, Nabal H, Anis E, Rosenmann H, Milo R. Is There Horizontal Transmission of Creutzfeldt-Jakob Disease? Neuroepidemiology 2023; 57:156-161. [PMID: 37044081 DOI: 10.1159/000530407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/28/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Sporadic Creutzfeldt-Jakob disease (s-CJD) is a rare, fatal neurodegenerative disorder. Familial cases of Creutzfeldt-Jakob disease (f-CJD) due to mutations in the PRNP gene are even rarer around the world; however, in Israel there is a focus of f-CJD patients carrying the E200K mutation. As the number of CJD E200K carriers in Israel is high and increasing, transmission of CJD to normal people was suspected. If such transmission occurs, the incidence of s-CJD would be expected to increase as well, resulting in changes of the ratio of familial/sporadic cases. METHODS Using data from the National CJD Registry and official statistics on the Israeli population, we studied incidence rates of f-CJD and s-CJD for the period from 1985 to 2018 applying the Surveillance Epidemiology and End Results (SEER) statistical packet developed in the US National Cancer Institute. RESULTS In total, 621 CJD patients (405 f-CJD and 216 s-CJD) cases are included in the registry. In the cohort of f-CJD patients, the mean age-adjusted annual incidence rate over the abovementioned period was 1.88 ± 0.09 (95% CI: 1.7-2.08) per 1,000,000. In the cohort of s-CJD patients, the mean age-adjusted incidence rate over the same period was 0.93 ± 0.06 (95% CI: 0.81-1.06) per 1,000,000 people. No significant time trends were found over the observation period in either s-CJD or f-CJD. The ratio f-CJD/s-CJD decreases over the observation period from 2.2 to 1.80. CONCLUSION Israel has a high predominance of f-CJD compared to s-CJD. The mean incidence rate of s-CJD in Israel is similar to most countries. Between 1985 and 2018, the annual age-adjusted incidence rates for both forms of CJD remained stable. Thus, there is no evidence that CJD is transmitted from affected individuals to others.
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Affiliation(s)
- Yacov Balash
- Department of Neurology, Kaplan Medical Center, Rehovot, Israel,
| | - Esther Kahana
- Department of Neurology, Barzilai University Medical Center, Ashkelon, Israel
| | - Amos D Korczyn
- Departments of Neurology and Physiology and Pharmacology, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Meir Wolker
- Department of Neurology, Barzilai University Medical Center, Ashkelon, Israel
| | - Hadeel Nabal
- Division of Epidemiology, Ministry of Health, Jerusalem, Israel
| | - Emilia Anis
- Division of Epidemiology, Ministry of Health, Jerusalem, Israel
| | - Hanna Rosenmann
- Department of Neurology, the Agnes Ginges Center for Human Neurogenetics, Hadassah, Hebrew University Medical Center, Jerusalem, Israel
| | - Ron Milo
- Department of Neurology, Barzilai University Medical Center, Ashkelon, Israel
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Bakal JA, Charlton CL, Hlavay B, Jansen GH, Svenson LW, Power C. Progressive multifocal leukoencephalopathy and Creutzfeldt-Jakob disease: population-wide incidences, comorbidities, costs of care, and outcomes. J Neurovirol 2021; 27:476-481. [PMID: 33978904 DOI: 10.1007/s13365-021-00983-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 10/21/2022]
Abstract
Neurological disorders associated with chronic infections are often progressive as well as challenging to diagnose and manage. Among 4.4 million persons from 2004 to 2019 receiving universal health, progressive multifocal leukoencephalopathy (PML, n = 58) and Creutzfeldt-Jakob disease (CJD, n = 93) cases were identified, revealing stable yearly incidence rates with divergent comorbidities: HIV/AIDS affected 37.8% of PML cases while cerebrovascular disease affected 26.9% of CJD cases. Most CJD cases died within 1 year (73%) although PML cases lived beyond 5 years (34.1%) despite higher initial costs of care. PML and CJD represent important neurological disorders with evolving risk variables and impact on health care.
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Affiliation(s)
- J A Bakal
- Provincial Research Data Services-Alberta Health Services, Edmonton, AB, Canada
| | - C L Charlton
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, AB, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
- Li Ki Sheng Institute of Virology, Edmonton, AB, Canada
| | - B Hlavay
- Department of Medicine, Medical Research Centre, University of Alberta, 6-11 Heritage, Edmonton, AB, Canada
| | - G H Jansen
- Division of Anatomical Pathology, University of Ottawa, Ottawa, ON, Canada
| | - L W Svenson
- Department of Medicine, Medical Research Centre, University of Alberta, 6-11 Heritage, Edmonton, AB, Canada
- Analytics & Performance Reporting Branch, Alberta Health, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - C Power
- Department of Medicine, Medical Research Centre, University of Alberta, 6-11 Heritage, Edmonton, AB, Canada.
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Clinical manifestations and polysomnography-based analysis in nine cases of probable sporadic Creutzfeldt-Jakob disease. Neurol Sci 2021; 42:4209-4219. [PMID: 33559029 DOI: 10.1007/s10072-021-05102-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 01/28/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE To summarize the clinical characteristics of patients with sporadic Creutzfeldt-Jakob disease (sCJD), analyze its sleep disorder characteristics using polysomnography (PSG), and compare sleep disturbances with those of fatal familial insomnia (FFI). PATIENTS AND METHODS We retrospectively reviewed the sleep disturbances; cerebrospinal fluid (CSF) protein 14-3-3 (CSF-14-3-3 protein); prion protein gene, PRNP; magnetic resonance imaging; and electroencephalogram (EEG) of nine sCJD patients RESULTS: Of the nine sCJD patients, six were positive for CSF-14-3-3 protein. In the eight patients who completed diffusion-weighted imaging, seven showed cortical "ribbons sign" and two showed high signal in the basal ganglia. All nine patients had an EEG, which showed an increase in background slow waves; moreover, four showed typical periodic sharp wave complexes. The codon diversity at position 129, 219 of nine patients were MM, EE. Almost all nine patients had sleep disturbances such as insomnia, hypersomnia, and periodic limb movement disorder (PLMD). Five patients completed PSG, which demonstrated severe sleep structure disorder, prolonged total waking time, significantly reduced sleep efficiency, and absent rapid eye movement in some severe patients. CONCLUSION Sleep disturbances are common in sCJD patients, manifested as insomnia, lethargy, and PLMD. The sCJD patients often demonstrate severe sleep structure disorder through PSG, which is similar to patients with FFI.
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Nishimura Y, Harada K, Koyama T, Hagiya H, Otsuka F. A nationwide trend analysis in the incidence and mortality of Creutzfeldt-Jakob disease in Japan between 2005 and 2014. Sci Rep 2020; 10:15509. [PMID: 32968173 PMCID: PMC7511945 DOI: 10.1038/s41598-020-72519-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/26/2020] [Indexed: 12/30/2022] Open
Abstract
In the era of hyper-ageing, Creutzfeldt-Jakob disease (CJD) can become more prevalent as an important cause of dementia. This study aimed to evaluate the trends in crude and age-adjusted CJD-associated mortality and incidence rates in Japan using national vital statistics data on CJD-associated deaths among individuals aged over 50 years, as well as the government-funded nationwide CJD surveillance data (pertaining to the years 2005-2014) in Japan. The data were analysed using the Joinpoint Regression Program to estimate the long-term trends and average annual percentage changes (AAPCs). Overall, the AAPCs of age-adjusted CJD-associated mortality rates rose significantly over the study period (3.2%; 95% confidence interval [CI] 1.4-5.1%). The AAPC of the age-adjusted incidence rates also increased (overall 6.4%; 95% CI 4.7-8.1%). The CJD-associated increases in the mortality and incidence rates were especially prominent among adults over the age of 70 years. Given this trend in aging of population, the disease burden of CJD will continue to increase in severity. Our findings thus recommend that policymakers be aware of the importance of CJD and focus on preparing to address the increasing prevalence of dementia.
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Affiliation(s)
- Yoshito Nishimura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Ko Harada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Toshihiro Koyama
- Department of Pharmaceutical Biomedicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, 7008558, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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D’Arcy CE, Bitnun A, Coulthart MB, D’Amour R, Friedman J, Knox JD, Rapoport A, Carter S, Widjaja E, Hazrati LN, Jansen GH. Sporadic Creutzfeldt-Jakob Disease in a Young Girl With Unusually Long Survival. J Neuropathol Exp Neurol 2019; 78:373-378. [DOI: 10.1093/jnen/nlz013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Colleen E D’Arcy
- Division of Pathology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ari Bitnun
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Michael B Coulthart
- Canadian Creutzfeldt-Jakob Disease Surveillance System, Public Health Agency of Canada, Ottawa, Canada
| | - Rolande D’Amour
- Canadian Creutzfeldt-Jakob Disease Surveillance System, Public Health Agency of Canada, Ottawa, Canada
| | - Jeremy Friedman
- Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - J David Knox
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Adam Rapoport
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Snead Carter
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Elysa Widjaja
- Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Lili-Naz Hazrati
- Division of Pathology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Gerard H Jansen
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
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Coulthart MB, Geschwind MD, Qureshi S, Phielipp N, Demarsh A, Abrams JY, Belay E, Gambetti P, Jansen GH, Lang AE, Schonberger LB. A case cluster of variant Creutzfeldt-Jakob disease linked to the Kingdom of Saudi Arabia. Brain 2016; 139:2609-2616. [PMID: 27671029 PMCID: PMC5082737 DOI: 10.1093/brain/aww206] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/15/2016] [Accepted: 06/23/2016] [Indexed: 11/12/2022] Open
Abstract
As of mid-2016, 231 cases of variant Creutzfeldt-Jakob disease-the human form of a prion disease of cattle, bovine spongiform encephalopathy-have been reported from 12 countries. With few exceptions, the affected individuals had histories of extended residence in the UK or other Western European countries during the period (1980-96) of maximum global risk for human exposure to bovine spongiform encephalopathy. However, the possibility remains that other geographic foci of human infection exist, identification of which may help to foreshadow the future of the epidemic. We report results of a quantitative analysis of country-specific relative risks of infection for three individuals diagnosed with variant Creutzfeldt-Jakob disease in the USA and Canada. All were born and raised in Saudi Arabia, but had histories of residence and travel in other countries. To calculate country-specific relative probabilities of infection, we aligned each patient's life history with published estimates of probability distributions of incubation period and age at infection parameters from a UK cohort of 171 variant Creutzfeldt-Jakob disease cases. The distributions were then partitioned into probability density fractions according to time intervals of the patient's residence and travel history, and the density fractions were combined by country. This calculation was performed for incubation period alone, age at infection alone, and jointly for incubation and age at infection. Country-specific fractions were normalized either to the total density between the individual's dates of birth and symptom onset ('lifetime'), or to that between 1980 and 1996, for a total of six combinations of parameter and interval. The country-specific relative probability of infection for Saudi Arabia clearly ranked highest under each of the six combinations of parameter × interval for Patients 1 and 2, with values ranging from 0.572 to 0.998, respectively, for Patient 2 (age at infection × lifetime) and Patient 1 (joint incubation and age at infection × 1980-96). For Patient 3, relative probabilities for Saudi Arabia were not as distinct from those for other countries using the lifetime interval: 0.394, 0.360 and 0.378, respectively, for incubation period, age at infection and jointly for incubation and age at infection. However, for this patient Saudi Arabia clearly ranked highest within the 1980-96 period: 0.859, 0.871 and 0.865, respectively, for incubation period, age at infection and jointly for incubation and age at infection. These findings support the hypothesis that human infection with bovine spongiform encephalopathy occurred in Saudi Arabia.
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Affiliation(s)
- Michael B Coulthart
- 1 Canadian Creutzfeldt-Jakob Disease Surveillance System, Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Michael D Geschwind
- 2 Memory and Aging Center, Box 1207, University of California, San Francisco (UCSF), San Francisco, CA 94143-1207, USA
| | - Shireen Qureshi
- 3 Consultant Neurologist, Dhahran Health Center, Dhahran, Saudi Arabia
| | - Nicolas Phielipp
- 4 Department of Neurology, Parkinson's and Movement Disorders Program, University of California Irvine, Irvine, CA 92697, USA
| | - Alex Demarsh
- 5 Zoonoses Division, Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Joseph Y Abrams
- 6 Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Ermias Belay
- 6 Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Pierluigi Gambetti
- 7 Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Gerard H Jansen
- 8 Eastern Ontario Regional Laboratory Association, Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada
| | - Anthony E Lang
- 7 Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Lawrence B Schonberger
- 6 Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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A new diagnostic test for Creutzfeldt-Jakob disease: Real-time quaking-induced conversion (RT-QulC). ACTA ACUST UNITED AC 2015; 41:192-195. [PMID: 29769951 DOI: 10.14745/ccdr.v41i08a02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Currently, definitive diagnoses of Creutzfeldt-Jakob disease (CJD) require an examination of the brains of deceased patients. In cooperation with an international consortium, Canada's National Microbiology Laboratory is performing a validation of a new test that can diagnose CJD in living patients. This test, the real-time quaking-induced conversion (RT-QuIC) assay, directly detects the disease associated form of the prion protein in cerebrospinal fluid. If validated, RT-QuIC will represent a major advance in the diagnoses of patients suspected to have CJD.
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What's new in Alzheimer disease? CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2015; 61:692. [PMID: 26273082 PMCID: PMC4541434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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