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Neurofilament light chain as biomarker in idiopathic intracranial hypertension.
Cephalalgia ( IF 4.9 ) Pub Date : 2020-07-29 , DOI: 10.1177/0333102420944866
Dagmar Beier 1, 2, 3 , Johanne Juhl Korsbæk 4, 5 , Jonna Skov Madsen 6, 7 , Dorte Aalund Olsen 6 , Laleh Dehghani Molander 8 , Snorre M Hagen 9 , Charlotte Teunissen 10 , Christoph P Beier 1, 2 , Rigmor Højland Jensen 4, 5
Affiliation  

Background

Damage of the optic nerve is the major complication of idiopathic intracranial hypertension. A biomarker indicative for optic nerve damage would help identifying high-risk patients requiring surgical procedures. Here, we studied the potential of cerebrospinal fluid neurofilament to predict idiopathic intracranial hypertension-induced optic nerve damage.

Methods

In two centers, serum and cerebrospinal fluid of 61 patients with clinically suspected idiopathic intracranial hypertension were prospectively collected. Neurofilament concentrations were measured and related to ophthalmological assessment.

Results

The average cerebrospinal fluid neurofilament concentration in patients with moderate and severe papilledema was increased compared to patients with minor and no papilledema (1755 ± 3507 pg/ml vs. 244 ± 102 pg/ml; p < 0.001). Cerebrospinal fluid neurofilament concentrations correlated with the maximal lumbar puncture opening pressure (r = 0.67, p < 0.001). In patients fulfilling the Friedman criteria for idiopathic intracranial hypertension with or without papilledema (n = 35), development of bilateral visual field defects and bilateral atrophy of the optic nerve were associated with increased average age-adjusted cerebrospinal fluid neurofilament concentrations. At last follow-up (n = 30), 8/13 of patients with increased, but only 3/17 with normal, cerebrospinal fluid neurofilament had developed bilateral visual field defects and/or bilateral optic nerve atrophy resulting in a sensitivity of 72.7% and a specificity of 73.7% of cerebrospinal fluid neurofilament to detect permanent optic nerve damage.

Conclusions

Cerebrospinal fluid neurofilament is a putative biomarker for optical nerve damage in idiopathic intracranial hypertension.



中文翻译:

神经丝轻链作为特发性颅内高压的生物标志物。

背景

视神经损伤是特发性颅内高压的主要并发症。指示视神经损伤的生物标志物将有助于识别需要外科手术的高危患者。在这里,我们研究了脑脊液神经丝预测特发性颅内高压引起的视神经损伤的潜力。

方法

在两个中心,前瞻性收集了 61 例临床疑似特发性颅内高压患者的血清和脑脊液。测量神经丝浓度并与眼科评估相关。

结果

与轻度和无视乳头水肿患者相比,中度和重度视乳头水肿患者的平均脑脊液神经丝浓度增加(1755 ± 3507 pg/ml vs. 244 ± 102 pg/ml;p  < 0.001)。脑脊液神经丝浓度与最大腰椎穿刺开口压力相关(r = 0.67,p < 0.001)。在符合弗里德曼特发性颅内高压标准的患者中,伴或不伴视乳头水肿(n = 35),双侧视野缺损和双侧视神经萎缩与平均年龄调整脑脊液神经丝浓度增加有关。在最后一次随访时(n = 30),8/13 的患者出现双侧视野缺损和/或双侧视神经萎缩,但只有 3/17 的脑脊液神经丝正常,导致敏感性为 72.7% 73.7% 的脑脊液神经丝检测永久性视神经损伤的特异性。

结论

脑脊液神经丝是特发性颅内高压视神经损伤的公认生物标志物。

更新日期:2020-07-30
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