Michael Geschwind, MD, PhD, FAAN, Memory and Aging Center, University of California, San Francisco, CA, discusses the diagnostic utility of cerebrospinal fluid (CSF) biomarkers in patients with rapidly progressive dementia (RPD), commenting on some of the most common proteins that have been used diagnostically in the past. Dr Geschwind goes on to describe the CSF real-time quaking-induced conversion (RT-QuIC) assay, which exploits the ability of pathological prion proteins present in a sample to induce misfolding and aggregation of normal prion protein, which can be monitored in real time using fluorescent dyes. Studies have found this method to have a high specificity and sensitivity; however, Dr Geschwind notes that around 15% of patients with prion disease will have a negative test result. This interview took place at the 18th Annual Congress on Controversies in Neurology (CONy 2024) in London, UK.
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