Raised Plasma Neurofilament Light Protein Levels After Rewarming Are Associated With Adverse Neurodevelopmental Outcomes in Newborns After Therapeutic Hypothermia
Aim: To determine the predictive value of plasma neurofilament light protein (NfL) as a prognostic marker for outcomes in babies who have undergone therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE).Method: NfL levels from three groups of term newborns were compared: (1) those wi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-10-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2020.562510/full |
| _version_ | 1818600052677935104 |
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| author | Divyen K. Shah Divyen K. Shah Ping K. Yip Akif Barlas Pavithira Tharmapoopathy Vennila Ponnusamy Vennila Ponnusamy Adina T. Michael-Titus Philippa Chisholm |
| author_facet | Divyen K. Shah Divyen K. Shah Ping K. Yip Akif Barlas Pavithira Tharmapoopathy Vennila Ponnusamy Vennila Ponnusamy Adina T. Michael-Titus Philippa Chisholm |
| author_sort | Divyen K. Shah |
| collection | DOAJ |
| description | Aim: To determine the predictive value of plasma neurofilament light protein (NfL) as a prognostic marker for outcomes in babies who have undergone therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE).Method: NfL levels from three groups of term newborns were compared: (1) those with mild HIE who did not receive TH, (2) newborns treated with TH who had minimal or no brain injury on MRI, and (3) newborns treated with TH who had substantial brain injury on MRI. Follow-up outcomes were collected from 18 months onward.Results: Follow-up was available for 33/37 (89%) of children. A cutoff NfL level >436 pg/ml after rewarming (median age 98 h) was associated with adverse outcome with a diagnostic sensitivity 75%, specificity 77%, PPV 75%, and NPV 77%. NfL levels at earlier time points were not predictive of outcome.Interpretation: This pilot study shows that persistently raised plasma NfL levels after rewarming are associated with adverse outcomes in babies with HIE who have undergone TH. |
| first_indexed | 2024-12-16T12:29:22Z |
| format | Article |
| id | doaj.art-fa118f3f1373492c86894a53dc1adcc8 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-16T12:29:22Z |
| publishDate | 2020-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-fa118f3f1373492c86894a53dc1adcc82022-12-21T22:31:44ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-10-011110.3389/fneur.2020.562510562510Raised Plasma Neurofilament Light Protein Levels After Rewarming Are Associated With Adverse Neurodevelopmental Outcomes in Newborns After Therapeutic HypothermiaDivyen K. Shah0Divyen K. Shah1Ping K. Yip2Akif Barlas3Pavithira Tharmapoopathy4Vennila Ponnusamy5Vennila Ponnusamy6Adina T. Michael-Titus7Philippa Chisholm8The Royal London Hospital, Barts Health NHS Trust, London, United KingdomThe Centre for Neuroscience, Surgery and Trauma, Barts and The London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London, United KingdomThe Centre for Neuroscience, Surgery and Trauma, Barts and The London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London, United KingdomThe Royal London Hospital, Barts Health NHS Trust, London, United KingdomThe Centre for Neuroscience, Surgery and Trauma, Barts and The London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London, United KingdomCentre for Genomics and Child Health, Barts and The London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London, United KingdomAshford and St. Peter's Hospitals NHS Foundation Trust, Chertsey, United KingdomThe Centre for Neuroscience, Surgery and Trauma, Barts and The London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London, United KingdomHomerton University Hospitals NHS Foundation Trust, London, United KingdomAim: To determine the predictive value of plasma neurofilament light protein (NfL) as a prognostic marker for outcomes in babies who have undergone therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE).Method: NfL levels from three groups of term newborns were compared: (1) those with mild HIE who did not receive TH, (2) newborns treated with TH who had minimal or no brain injury on MRI, and (3) newborns treated with TH who had substantial brain injury on MRI. Follow-up outcomes were collected from 18 months onward.Results: Follow-up was available for 33/37 (89%) of children. A cutoff NfL level >436 pg/ml after rewarming (median age 98 h) was associated with adverse outcome with a diagnostic sensitivity 75%, specificity 77%, PPV 75%, and NPV 77%. NfL levels at earlier time points were not predictive of outcome.Interpretation: This pilot study shows that persistently raised plasma NfL levels after rewarming are associated with adverse outcomes in babies with HIE who have undergone TH.https://www.frontiersin.org/articles/10.3389/fneur.2020.562510/fullnewbornhypoxic-ischemic encephalopathyneurodevelopmentneurofilament light proteintherapautic hypothermia |
| spellingShingle | Divyen K. Shah Divyen K. Shah Ping K. Yip Akif Barlas Pavithira Tharmapoopathy Vennila Ponnusamy Vennila Ponnusamy Adina T. Michael-Titus Philippa Chisholm Raised Plasma Neurofilament Light Protein Levels After Rewarming Are Associated With Adverse Neurodevelopmental Outcomes in Newborns After Therapeutic Hypothermia Frontiers in Neurology newborn hypoxic-ischemic encephalopathy neurodevelopment neurofilament light protein therapautic hypothermia |
| title | Raised Plasma Neurofilament Light Protein Levels After Rewarming Are Associated With Adverse Neurodevelopmental Outcomes in Newborns After Therapeutic Hypothermia |
| title_full | Raised Plasma Neurofilament Light Protein Levels After Rewarming Are Associated With Adverse Neurodevelopmental Outcomes in Newborns After Therapeutic Hypothermia |
| title_fullStr | Raised Plasma Neurofilament Light Protein Levels After Rewarming Are Associated With Adverse Neurodevelopmental Outcomes in Newborns After Therapeutic Hypothermia |
| title_full_unstemmed | Raised Plasma Neurofilament Light Protein Levels After Rewarming Are Associated With Adverse Neurodevelopmental Outcomes in Newborns After Therapeutic Hypothermia |
| title_short | Raised Plasma Neurofilament Light Protein Levels After Rewarming Are Associated With Adverse Neurodevelopmental Outcomes in Newborns After Therapeutic Hypothermia |
| title_sort | raised plasma neurofilament light protein levels after rewarming are associated with adverse neurodevelopmental outcomes in newborns after therapeutic hypothermia |
| topic | newborn hypoxic-ischemic encephalopathy neurodevelopment neurofilament light protein therapautic hypothermia |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2020.562510/full |
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