Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light.
Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light.
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DOI：
10.1371/journal.pone.0132177
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Bellander BM
中科院分区：
文献类型：
--
作者：
Al Nimer F;Thelin E;Nyström H;Dring AM;Svenningsson A;Piehl F;Nelson DW;Bellander BM
创伤性脑损伤（TBI）是世界范围内死亡和残疾的常见原因。早期确定损伤严重程度对改善护理至关重要。神经丝光（NF-L）已被引入作为神经炎性/变性疾病中神经轴突损伤的标志物。在这项研究中，我们确定了血清（s-）和脑脊液（CSF-）NF-L水平对结果的预测能力，并探讨了它们与弥漫性轴索损伤（DAI）的潜在相关性。总共有182名患有TBI的患者被纳入1级创伤中心的神经重症监护室。获得S-NF-L水平，以及S100 B和神经元特异性烯醇化酶（NSE）。在脑室造口术的子队列（n = 84）中测量CSF-NF-L。临床和神经放射学参数，包括计算机断层扫描（CT）和磁共振成像，包括在分析中。在损伤后6至12个月使用格拉斯哥结局评分（1-5）评估结局。在单变量比例优势分析中，平均s-NF-L、-S100 B和-NSE水平与结局相关的伪R2 Nagelkerke分别为0.062、0.214和0.074。在多变量分析中，除了包括核心参数的模型之外，（伪R2 0.33朝向结果;年龄、格拉斯哥昏迷评分、瞳孔反应、斯德哥尔摩CT评分、简化损伤严重程度评分、S100 B），S-NF-L产生额外的0.023伪R2和显著更好的模型（p = 0.006）DAI或CT评估的颅内损伤与NF-L之间没有发现相关性。因此，我们的研究表明，S-NF-L与TBI结果相关，即使用于S100 B模型，表明对预测的独立贡献，可能是通过反映不同的病理生理过程，而不可能使用常规神经放射学进行监测。虽然我们没有发现NF-L对DAI的预测价值，但这不能完全排除。我们建议进一步的研究，轴突损伤的体积定量，并延长采样时间，以更好地确定NF-L和DAI之间的联系。
Traumatic brain injury (TBI) is a common cause of death and disability, worldwide. Early determination of injury severity is essential to improve care. Neurofilament light (NF-L) has been introduced as a marker of neuroaxonal injury in neuroinflammatory/-degenerative diseases. In this study we determined the predictive power of serum (s-) and cerebrospinal fluid (CSF-) NF-L levels towards outcome, and explored their potential correlation to diffuse axonal injury (DAI). A total of 182 patients suffering from TBI admitted to the neurointensive care unit at a level 1 trauma center were included. S-NF-L levels were acquired, together with S100B and neuron-specific enolase (NSE). CSF-NF-L was measured in a subcohort (n = 84) with ventriculostomies. Clinical and neuro-radiological parameters, including computerized tomography (CT) and magnetic resonance imaging, were included in the analyses. Outcome was assessed 6 to 12 months after injury using the Glasgow Outcome Score (1-5). In univariate proportional odds analyses mean s-NF-L, -S100B and -NSE levels presented a pseudo-R2 Nagelkerke of 0.062, 0.214 and 0.074 in correlation to outcome, respectively. In a multivariate analysis, in addition to a model including core parameters (pseudo-R2 0.33 towards outcome; Age, Glasgow Coma Scale, pupil response, Stockholm CT score, abbreviated injury severity score, S100B), S-NF-L yielded an extra 0.023 pseudo-R2 and a significantly better model (p = 0.006) No correlation between DAI or CT assessed-intracranial damage and NF-L was found. Our study thus demonstrates that S-NF-L correlates to TBI outcome, even if used in models with S100B, indicating an independent contribution to the prediction, perhaps by reflecting different pathophysiological processes, not possible to monitor using conventional neuroradiology. Although we did not find a predictive value of NF-L for DAI, this cannot be completely excluded. We suggest further studies, with volume quantification of axonal injury, and a prolonged sampling time, in order to better determine the connection between NF-L and DAI.
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影响因子：
11
作者：
Disanto, Giulio;Adiutori, Rocco;Ramagopalan, Sreeram V.
通讯作者：
Ramagopalan, Sreeram V.
DOI：
10.1097/00005373-197403000-00001
发表时间：
1974-01-01
影响因子：
--
作者：
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通讯作者：
LONG, WB
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作者：
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影响因子：
2.2
作者：
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通讯作者：
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