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CSF biomarkers for improved prognostic accuracy in acute CNS disease

Petzold, A; (2007) CSF biomarkers for improved prognostic accuracy in acute CNS disease. Neurological Research , 29 (7) 691 - 708. 10.1179/016164107X240080. Green open access

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Abstract

Providing an accurate prognosis in patients suffering from acute central nervous system (CNS) disease is difficult. The extent and location of the primary CNS injury is crucial for mortality and morbidity. Secondary injury adds considerably to the CNS insult. The prognosis in an individual patient depends on the combination of primary and secondary CNS damage together with systemic complications. The clinical challenge of an accurate prognosis is therefore aided by both quantitative techniques, able to estimate the degree of CNS damage and qualitative techniques, which identify the site of the lesion. Here the contribution of cerebrospinal fluid (CSF) biomarkers to improving the prognostic accuracy is reviewed. First, current definitions in biomarker research are introduced. Second, the role of the blood-brain barrier (BBB) is discussed. Third, the physiologic and anatomical constraints of the CSF are summarized. Fourth, following an overview on CSF biomarkers, cell type-specific CSF biomarkers and more global CSF biomarkers for parenchymal CNS damage are reviewed in detail. The release of these biomarkers from dying cells is illustrated by a video of a laser-dissected neuron. Finally, the evidence for improving prognostic accuracy is summarized and recommendations are made for future biomarker research.

Type: Article
Title: CSF biomarkers for improved prognostic accuracy in acute CNS disease
Open access status: An open access version is available from UCL Discovery
DOI: 10.1179/016164107X240080
Publisher version: http://dx.doi.org/10.1179/016164107X240080
Language: English
Additional information: © W. S. Maney & Son Ltd. Made available with permission.
Keywords: 4-hydroxynonenal, albumin, alpha-spectrin, alpha(1) BG, alpha-internexin, amyloid beta peptide, TRAUMATIC BRAIN-INJURY, MYELIN BASIC-PROTEIN, NEURON-SPECIFIC ENOLASE, FIBRILLARY ACIDIC PROTEIN, GUILLAIN-BARRE-SYNDROME, VENTRICULAR CEREBROSPINAL-FLUID, ACUTE ISCHEMIC-STROKE, ANEURYSMAL SUBARACHNOID HEMORRHAGE, GLASGOW COMA SCALE, ACUTE SCLEROSING PANENCEPHALITIS
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: http://discovery.ucl.ac.uk/id/eprint/18932
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