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Related Experiment Video

Updated: Feb 4, 2026

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RT-QuIC: a new test for sporadic CJD.

Alison J E Green1

  • 1Centre for Clinical Brain Sciences, The National CJD Research & Surveillance Unit, University of Edinburgh, Edinburgh, UK alison.green@ed.ac.uk.

Practical Neurology
|October 5, 2018
PubMed
Summary

Real-time quaking-induced conversion (RT-QuIC) assays significantly improve sporadic Creutzfeldt-Jakob disease (CJD) diagnosis. Optimal sample quality, with clear cerebrospinal fluid (CSF) and low protein, ensures accurate RT-QuIC test results for CJD detection.

Keywords:
CSF RT-QuICcerebrospinal fluidcreutzfeldt-jakob diseaseprion disease

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Area of Science:

  • Neurology
  • Biochemistry
  • Medical Diagnostics

Background:

  • Sporadic Creutzfeldt-Jakob disease (sCJD) diagnosis presents clinical challenges.
  • Prion protein (PrP) misfolding is central to sCJD pathogenesis.
  • Real-time quaking-induced conversion (RT-QuIC) assays offer a promising diagnostic tool.

Purpose of the Study:

  • To evaluate the diagnostic performance of CSF RT-QuIC for sCJD.
  • To identify factors affecting RT-QuIC assay interpretation.
  • To establish optimal cerebrospinal fluid (CSF) sample quality guidelines for RT-QuIC.

Main Methods:

  • Cerebrospinal fluid (CSF) samples were analyzed using RT-QuIC assays.
  • The ability of pathological prion protein (PrPSc) to induce PrP misfolding and aggregation was monitored.
  • Assay sensitivity and specificity were determined.
  • The impact of CSF cell counts and protein concentrations on RT-QuIC results was assessed.

Main Results:

  • CSF RT-QuIC demonstrated high diagnostic performance with 92% sensitivity and 100% specificity.
  • Elevated CSF white blood cell counts and total protein concentrations can interfere with RT-QuIC trace interpretation.
  • Clear, colorless CSF with <10 x10^6/L white cells and <1 g/L total protein is recommended.

Conclusions:

  • RT-QuIC assays are highly effective for diagnosing sporadic CJD.
  • Optimizing CSF sample quality is crucial for reliable RT-QuIC results.
  • Standardized sample requirements will enhance the clinical utility of RT-QuIC in CJD diagnostics.