RT Journal Article
SR Electronic
T1 Serum neurofilament light chain is a biomarker of human spinal cord injury severity and outcome
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 273
OP 279
DO 10.1136/jnnp-2013-307454
VO 86
IS 3
A1 Jens Kuhle
A1 Johanna Gaiottino
A1 David Leppert
A1 Axel Petzold
A1 Jonathan P Bestwick
A1 Andrea Malaspina
A1 Ching-Hua Lu
A1 Ruth Dobson
A1 Giulio Disanto
A1 Niklas Norgren
A1 Ahuva Nissim
A1 Ludwig Kappos
A1 John Hurlbert
A1 V Wee Yong
A1 Gavin Giovannoni
A1 Steven Casha
YR 2015
UL http://jnnp.bmj.com/content/86/3/273.abstract
AB Background Neurofilaments (Nf) are major structural proteins that occur exclusively in neurons. In spinal cord injury (SCI), the severity of disease is quantified by clinical measures that have limited sensitivity and reliability, and no blood-based biomarker has been established to further stratify the degree of injury. We aimed to examine a serum-based NfL immunoassay as predictor of the clinical outcome in SCI. Methods Longitudinal measurement of serum NfL was performed in patients with central cord syndrome (CCS, n=4), motor-incomplete SCI (iSCI, n=10), motor-complete SCI (cSCI, n=13) and healthy controls (HC, n=67), and correlated with clinical severity, neurological outcome, and neuroprotective effect of the drug minocycline. Results Baseline NfL levels were higher in iSCI (21 pg/mL) and cSCI (70 pg/mL) than in HC (5 pg/mL, p=0.006 and p<0.001) and CCS (6 pg/mL, p=0.025 and p=0.010). Levels increased over time (p<0.001) and remained higher in cSCI versus iSCI (p=0.011) and than in CCS (p<0.001). NfL levels correlated with American Spinal Injury Association (ASIA) motor score at baseline (r=−0.53, p=0.004) and after 24 h (r=−0.69, p<0.001) and 3–12-month motor outcome (baseline NfL: r=−0.43, p=0.026 and 24 h NfL: r=−0.72, p<0.001). Minocycline treatment showed decreased NfL levels in the subgroup of cSCI patients. Conclusions Serum NfL concentrations in SCI patients show a close correlation with acute severity and neurological outcome. Our data provide evidence that serum NfL is of prognostic value in SCI patients for the first time. Further, blood NfL levels may qualify as drug response markers in SCI.