Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light.
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 deter...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2015-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4489843?pdf=render |
| _version_ | 1828787629434339328 |
|---|---|
| author | Faiez Al Nimer Eric Thelin Harriet Nyström Ann M Dring Anders Svenningsson Fredrik Piehl David W Nelson Bo-Michael Bellander |
| author_facet | Faiez Al Nimer Eric Thelin Harriet Nyström Ann M Dring Anders Svenningsson Fredrik Piehl David W Nelson Bo-Michael Bellander |
| author_sort | Faiez Al Nimer |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-12T00:36:15Z |
| format | Article |
| id | doaj.art-1dfeb1d4ebbc453a9d3366a9c74290c6 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T00:36:15Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-1dfeb1d4ebbc453a9d3366a9c74290c62022-12-22T00:44:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01107e013217710.1371/journal.pone.0132177Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light.Faiez Al NimerEric ThelinHarriet NyströmAnn M DringAnders SvenningssonFredrik PiehlDavid W NelsonBo-Michael BellanderTraumatic 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.http://europepmc.org/articles/PMC4489843?pdf=render |
| spellingShingle | Faiez Al Nimer Eric Thelin Harriet Nyström Ann M Dring Anders Svenningsson Fredrik Piehl David W Nelson Bo-Michael Bellander Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light. PLoS ONE |
| title | Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light. |
| title_full | Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light. |
| title_fullStr | Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light. |
| title_full_unstemmed | Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light. |
| title_short | Comparative Assessment of the Prognostic Value of Biomarkers in Traumatic Brain Injury Reveals an Independent Role for Serum Levels of Neurofilament Light. |
| title_sort | comparative assessment of the prognostic value of biomarkers in traumatic brain injury reveals an independent role for serum levels of neurofilament light |
| url | http://europepmc.org/articles/PMC4489843?pdf=render |
| work_keys_str_mv | AT faiezalnimer comparativeassessmentoftheprognosticvalueofbiomarkersintraumaticbraininjuryrevealsanindependentroleforserumlevelsofneurofilamentlight AT ericthelin comparativeassessmentoftheprognosticvalueofbiomarkersintraumaticbraininjuryrevealsanindependentroleforserumlevelsofneurofilamentlight AT harrietnystrom comparativeassessmentoftheprognosticvalueofbiomarkersintraumaticbraininjuryrevealsanindependentroleforserumlevelsofneurofilamentlight AT annmdring comparativeassessmentoftheprognosticvalueofbiomarkersintraumaticbraininjuryrevealsanindependentroleforserumlevelsofneurofilamentlight AT anderssvenningsson comparativeassessmentoftheprognosticvalueofbiomarkersintraumaticbraininjuryrevealsanindependentroleforserumlevelsofneurofilamentlight AT fredrikpiehl comparativeassessmentoftheprognosticvalueofbiomarkersintraumaticbraininjuryrevealsanindependentroleforserumlevelsofneurofilamentlight AT davidwnelson comparativeassessmentoftheprognosticvalueofbiomarkersintraumaticbraininjuryrevealsanindependentroleforserumlevelsofneurofilamentlight AT bomichaelbellander comparativeassessmentoftheprognosticvalueofbiomarkersintraumaticbraininjuryrevealsanindependentroleforserumlevelsofneurofilamentlight |