Mood Changes May Be a Prodromal Symptom in Sporadic Creutzfeldt-Jakob Disease
Mood changes may precede symptom onset in sporadic Creutzfeldt-Jakob disease (sCJD) as early as 3 years, according to the findings from a retrospective case-control study published in JAMA Neurology.
Given the rarity of sCJD occurrence, little is known about the prodromal stage of the disease. Study authors endeavored to identify potential risk factors by comparing drug prescription patterns in the years leading up to symptom onset between sCJD patients and matched controls.
Using data from the Austrian Reference Center for Human Prion Diseases, authors analyzed data from 129 autopsy-confirmed cases of sCJD (median [IQR] age, 68.9 [62.4-75.5] years; 67 female [51.9%]) and 1,350 matched controls (fulfilling the set minimum of 10 control individuals per sCJD patient, matched by sex, age at onset, and area of residence). Confirmed sCJD patients were also linked with insurance claims data.
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Researchers found that across the examined drug classes, patients with sCJD were significantly more likely to have been prescribed selective serotonin reuptake inhibitors (SSRIs), commonly used to treat mood disorders, in the year prior to disease onset (odds ratio, 2.86; 95% CI, 1.63-4.95; P < .001). Additionally, SSRI prescription rates began rising 3 years before the onset of sCJD symptoms.
The study also assessed whether SSRI use correlated with survival in sCJD patients but found no significant association.
“Although sCJD remains an extremely rare cause of mood alterations, increased vigilance for neurodegenerative diseases in this setting could eventually help to extend the diagnostic window,” Raphael Wurm, MD, department of neurology, Medical University of Vienna, Austria, and co-authors concluded.
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