Cerebrospinal fluid levels of GFAP and pNF-H are elevated in patients with chronic spinal cord injury and neurological deterioration
Holmström, Ulrika ; Tsitsopoulos, Parmenion P. ; Holtz, Anders ; Salci, Konstantin ; Shaw, Gerry ; Mondello, Stefania and Marklund, Niklas LU
(2020)
In Acta Neurochirurgica
162(9).
p.2075-2086
- Abstract
Background: Years after a traumatic spinal cord injury (SCI), a subset of patients may develop progressive clinical deterioration due to intradural scar formation and spinal cord tethering, with or without an associated syringomyelia. Meningitis, intradural hemorrhages, or intradural tumor surgery may also trigger glial scar formation and spinal cord tethering, leading to neurological worsening. Surgery is the treatment of choice in these chronic SCI patients. Objective: We hypothesized that cerebrospinal fluid (CSF) and plasma biomarkers could track ongoing neuronal loss and scar formation in patients with spinal cord tethering and are associated with clinical symptoms. Methods: We prospectively enrolled 12 patients with spinal cord... (More)
Background: Years after a traumatic spinal cord injury (SCI), a subset of patients may develop progressive clinical deterioration due to intradural scar formation and spinal cord tethering, with or without an associated syringomyelia. Meningitis, intradural hemorrhages, or intradural tumor surgery may also trigger glial scar formation and spinal cord tethering, leading to neurological worsening. Surgery is the treatment of choice in these chronic SCI patients. Objective: We hypothesized that cerebrospinal fluid (CSF) and plasma biomarkers could track ongoing neuronal loss and scar formation in patients with spinal cord tethering and are associated with clinical symptoms. Methods: We prospectively enrolled 12 patients with spinal cord tethering and measured glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCH-L1), and phosphorylated Neurofilament-heavy (pNF-H) in CSF and blood. Seven patients with benign lumbar intradural tumors and 7 patients with cervical radiculopathy without spinal cord involvement served as controls. Results: All evaluated biomarker levels were markedly higher in CSF than in plasma, without any correlation between the two compartments. When compared with radiculopathy controls, CSF GFAP and pNF-H levels were higher in patients with spinal cord tethering (p ≤ 0.05). In contrast, CSF UCH-L1 levels were not altered in chronic SCI patients when compared with either control groups. Conclusions: The present findings suggest that in patients with spinal cord tethering, CSF GFAP and pNF-H levels might reflect ongoing scar formation and neuronal injury potentially responsible for progressive neurological deterioration.
(Less)
- author
- Holmström, Ulrika
; Tsitsopoulos, Parmenion P.
; Holtz, Anders
; Salci, Konstantin
; Shaw, Gerry
; Mondello, Stefania
and Marklund, Niklas
LU
- organization
- publishing date
- 2020-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Biomarkers, Cerebrospinal fluid, Glial fibrillary acidic protein (GFAP), Neurofilament, Post-traumatic myelopathy, Spinal cord injury, Syringomyelia, Tethering of the spinal cord (TSC), Ubiquitin C-terminal hydrolase L1 (UCH-L1)
- in
- Acta Neurochirurgica
- volume
- 162
- issue
- 9
- pages
- 12 pages
- publisher
- Springer
- external identifiers
-
- scopus:85087062399
- pmid:32588294
- ISSN
- 0001-6268
- DOI
- 10.1007/s00701-020-04422-6
- language
- English
- LU publication?
- yes
- id
- f204e92a-f61e-46e1-8592-c12a6a2779a8
- date added to LUP
- 2020-07-13 13:05:34
- date last changed
- 2024-06-12 17:14:50
@article{f204e92a-f61e-46e1-8592-c12a6a2779a8,
abstract = {{<p>Background: Years after a traumatic spinal cord injury (SCI), a subset of patients may develop progressive clinical deterioration due to intradural scar formation and spinal cord tethering, with or without an associated syringomyelia. Meningitis, intradural hemorrhages, or intradural tumor surgery may also trigger glial scar formation and spinal cord tethering, leading to neurological worsening. Surgery is the treatment of choice in these chronic SCI patients. Objective: We hypothesized that cerebrospinal fluid (CSF) and plasma biomarkers could track ongoing neuronal loss and scar formation in patients with spinal cord tethering and are associated with clinical symptoms. Methods: We prospectively enrolled 12 patients with spinal cord tethering and measured glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCH-L1), and phosphorylated Neurofilament-heavy (pNF-H) in CSF and blood. Seven patients with benign lumbar intradural tumors and 7 patients with cervical radiculopathy without spinal cord involvement served as controls. Results: All evaluated biomarker levels were markedly higher in CSF than in plasma, without any correlation between the two compartments. When compared with radiculopathy controls, CSF GFAP and pNF-H levels were higher in patients with spinal cord tethering (p ≤ 0.05). In contrast, CSF UCH-L1 levels were not altered in chronic SCI patients when compared with either control groups. Conclusions: The present findings suggest that in patients with spinal cord tethering, CSF GFAP and pNF-H levels might reflect ongoing scar formation and neuronal injury potentially responsible for progressive neurological deterioration.</p>}},
author = {{Holmström, Ulrika and Tsitsopoulos, Parmenion P. and Holtz, Anders and Salci, Konstantin and Shaw, Gerry and Mondello, Stefania and Marklund, Niklas}},
issn = {{0001-6268}},
keywords = {{Biomarkers; Cerebrospinal fluid; Glial fibrillary acidic protein (GFAP); Neurofilament; Post-traumatic myelopathy; Spinal cord injury; Syringomyelia; Tethering of the spinal cord (TSC); Ubiquitin C-terminal hydrolase L1 (UCH-L1)}},
language = {{eng}},
number = {{9}},
pages = {{2075--2086}},
publisher = {{Springer}},
series = {{Acta Neurochirurgica}},
title = {{Cerebrospinal fluid levels of GFAP and pNF-H are elevated in patients with chronic spinal cord injury and neurological deterioration}},
url = {{http://dx.doi.org/10.1007/s00701-020-04422-6}},
doi = {{10.1007/s00701-020-04422-6}},
volume = {{162}},
year = {{2020}},
}