Serum neurofilament light as biomarker of seizure-related neuronal injury in status epilepticus.
Serum neurofilament light as biomarker of seizure-related neuronal injury in status epilepticus.
复制标题
血清神经丝光作为癫痫癫痫中癫痫发作相关神经元损伤的生物标志物。
作者：
癫痫持续状态（SE）中神经元损伤的生物标志物对于临床和研究目的具有重要意义。在一项回顾性横断面研究中，测量了SE患者（30例受试者）、耐药性癫痫患者（30例受试者）和健康对照（30例受试者）的血清神经丝轻链（NfL）水平。SE患者的血清NfL水平（中位数= 26.15 pg/ml）高于癫痫患者（中位数= 7.35 pg/ml）和健康对照组（中位数= 6.81 pg/ml; p <0.001）。在SE患者中，血清NfL水平与脑脊液（CSF）NfL水平高度相关（τ = .68，p < .001）以及CSF总tau（t-tau）水平（τ = .627，p < .001）;持续时间>24小时的SE较高（p = .013），难治性/超难治性SE（p = 0.004），以及在30天内死亡或临床状况恶化的患者（p = 0.001）。数值>28.8 pg/ml预测30天临床恶化或死亡（比值比[OR] = 10.83，95%置信区间[CI] = 1.96-59.83，p = 0.006）和SE不应性（OR = 9.33，95% CI = 1.51-57.65，p = 0.016）。总之，血清NfL水平在SE中升高，并与SE治疗反应、持续时间和结局相关，因此代表了癫痫发作相关神经元损伤的有希望的生物标志物。
Biomarkers of neuronal damage in status epilepticus (SE) would be of great relevance for clinical and research purposes. In a retrospective cross‐sectional study, serum neurofilament light chain (NfL) levels were measured in patients with SE (30 subjects), patients with drug‐resistant epilepsy (30 subjects), and healthy controls (30 subjects). Serum NfL levels were higher in patients with SE (median = 26.15 pg/ml) compared to both epilepsy patients (median = 7.35 pg/ml) and healthy controls (median = 6.81 pg/ml; p < .001). In patients with SE, serum NfL levels showed a high correlation with cerebrospinal fluid (CSF) NfL (τ = .68, p < .001) as well as with CSF total tau (t‐tau) levels (τ = .627, p < .001); they were higher in SE lasting >24 h (p = .013), in refractory/superrefractory SE (p = .004), and in patients who died within 30 days or who presented a worsening of clinical conditions (p = .001). Values of >28.8 pg/ml predicted 30‐day clinical worsening or death (odds ratio [OR] = 10.83, 95% confidence interval [CI] = 1.96–59.83, p = .006) and SE refractoriness (OR = 9.33, 95% CI = 1.51–57.65, p = .016). In conclusion, serum NfL levels are increased in SE and correlate with SE treatment response, duration, and outcomes, therefore representing a promising biomarker of seizure‐related neuronal damage.
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