Phosphorylated neurofilament heavy: A potential blood biomarker to evaluate the severity of acute spinal cord injuries in adults

Abstract

Aims:The aim of this study is to analyze the serial estimation of phosphorylated neurofilament heavy (pNF-H) in blood plasma that would act as a potential biomarker for early prediction of the neurological severity of acute spinal cord injuries (SCI) in adults.Settings and Design:Pilot study/observational study.Subjects and Methods:A total of 40 patients (28 cases and 12 controls) of spine injury were included in this study. In the enrolled cases, plasma level of pNF-H was evaluated in blood samples and neurological evaluation was performed by the American Spinal Injury Association Injury Scale at specified period. Serial plasma neurofilament heavy values were then correlated with the neurological status of these patients during follow-up visits and were analyzed statistically.Statistical Analysis Used:Statistical analysis was performed using GraphPad InStat software (version 3.05 for Windows, San Diego, CA, USA). The correlation analysis between the clinical progression and pNF-H expression was done using Spearman's correlation.Results:The mean baseline level of pNF-H in cases was 6.40 ± 2.49 ng/ml, whereas in controls it was 0.54 ± 0.27 ng/ml. On analyzing the association between the two by Mann–Whitney U–test, the difference in levels was found to be statistically significant. The association between the neurological progression and pNF-H expression was determined using correlation analysis (Spearman's correlation). At 95% confidence interval, the correlation coefficient was found to be 0.64, and the correlation was statistically significant.Conclusions:Plasma pNF-H levels were elevated in accordance with the severity of SCI. Therefore, pNF-H may be considered as a potential biomarker to determine early the severity of SCI in adult patients.

Time course and prognostic value of serum GFAP, pNFH, and S100β concentrations in dogs with complete spinal cord injury because of intervertebral disc extrusion

“…Neurofilaments are structural proteins found specifically in neurons. There are 3 different subunits, light, medium, and heavy chain, and of these, the light chain (NFL) and pNFH have been studied as biomarkers in human SCI . A meticulous study in rats established pNFH as a useful biomarker of axonal injury and evaluated the time course of release after spinal cord transection and contusion.…”

Cerebrospinal fluid levels of GFAP and pNF-H are elevated in patients with chronic spinal cord injury and neurological deterioration

“…We also hypothesized that progressive white matter pathology could be associated with neurological deterioration in chronic SCI. We therefore evaluated pNF-H, a main component of the axonal cytoskeleton that has previously been associated with acute worsening of cervical spondylotic myelopathy [49], and injury severity in acute SCI [48]. pNF-H was substantially increased in CSF of patients with spinal cord tethering compared with controls, thus suggesting ongoing axonal degeneration in this population and supporting its use as a potential biomarker for chronic SCI.…”

What's new in critical illness and injury science? Case reports: The first step on a path toward cure

“…Thus, the decision-making process becomes a group exercise, with the trauma/general surgeon, neurologist, and potentially many others involved, as seen in original articles published in the current edition of IJCIIS. [ 1 2 ]…”

“…Authors of both manuscripts are looking for objective measures to help determine when to intervene and the potential outcomes following an intervention. [ 1 2 ] The first study, by Singh, et al ., shows how a serum biomarker may provide an early prognostication of the severity of spinal cord injury in adult patients. [ 1 ] The second study, by Sandeep, et al ., represents an assessment of the surgical management of intracerebral hemorrhage, demonstrating that 10% of patients will recover and live independently at the 1 month temporal marker, with 20% of survivors becoming functionally independent at 6 months.…”

“…[ 1 2 ] The first study, by Singh, et al ., shows how a serum biomarker may provide an early prognostication of the severity of spinal cord injury in adult patients. [ 1 ] The second study, by Sandeep, et al ., represents an assessment of the surgical management of intracerebral hemorrhage, demonstrating that 10% of patients will recover and live independently at the 1 month temporal marker, with 20% of survivors becoming functionally independent at 6 months. [ 2 ] Moreover, these two articles fit well with the work describing an emergency transfusion score, demonstrating that the implementation of this score may help prevent inappropriate requests for blood transfusion.…”