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

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.