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Association of cerebrospinal fluid zinc-α2-glycoprotein and tau protein with temporal lobe epilepsy and related white matter impairment

Mo, Lijuan*; Ding, Xueying*; Tan, Changhong; Liu, Xi; Wei, Xin; Wang, Hui; Zhou, Wen; Chen, Lifen

doi: 10.1097/WNR.0000000000001252

This study aimed to identify the change of cerebrospinal fluid (CSF) zinc-α2-glycoprotein (ZAG), tau protein and phosphorylated tau 181 (P-Tau 181), and analyze their association with white matter impairment (WMI) in patients with temporal lobe epilepsy (TLE). Levels of ZAG, tau, and P-Tau 181 in CSF were measured by enzyme-linked immunosorbent assay. WMI was scored based on Scheltens and Ylikoski scales. ZAG and total tau (T-Tau) were decreased in CSF of patients with TLE than controls (P<0.05 and 0.01, respectively), but P-Tau 181 showed no statistical difference. P-Tau 181/T-Tau ratio was increased in CSF of patients with TLE than controls (P<0.01). Patients with TLE have severer WMIs than controls (P<0.01). Linear by linear association analysis showed a correlation between WMI and TLE (P<0.01), Spearman’s correlation analysis showed a correlation between T-Tau, P-Tau 181/T-Tau ratio and scores of WMIs (P<0.01). Receiver operating curves indicated apparent diagnostic value of T-Tau and P-Tau 181/T-Tau ratio in differentiating patients with TLE from controls (area under curve=1 and 0.936, respectively). ZAG also showed a lower but favorable diagnostic value (area under curve=0.771). ZAG, T-Tau, and P-Tau 181/T-Tau ratio in CSF may be potential biomarkers of WMI of TLE if further researched, and these findings may also be involved in potential mechanism of brain damage in TLE.

Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

* Lijuan Mo and Xueying Ding contributed equally to the writing of this article.

Correspondence to Lifen Chen, PhD, MD, 74 Linjiang Road, Yuzhong District, Chongqing 400010, China Tel: +86 236 369 3088; fax: +86 236 371 1527; e-mail:

Received January 27, 2019

Accepted March 11, 2019

© 2019 Wolters Kluwer Health | Lippincott Williams & Wilkins