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Neurofilament light protein levels in cerebrospinal fluid predict long-term disability of Guillain-Barre syndrome: A pilot study

Axelsson, M; Sjogren, M; Andersen, O; Blennow, K; Zetterberg, H; Lycke, J; (2018) Neurofilament light protein levels in cerebrospinal fluid predict long-term disability of Guillain-Barre syndrome: A pilot study. Acta Neurologica Scandinavica , 138 (2) pp. 143-150. 10.1111/ane.12927. Green open access

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Abstract

Objectives: Although the recovery from Guillain‐Barré syndrome (GBS) is good in most patients, some develop permanent severe disability or even die. Early predictors would increase the likelihood to identify patients at risk for poor outcome at the acute stage, allowing them intensified therapeutic intervention. Materials and Method: Eighteen patients with a history of GBS 9‐17 years ago were reassessed with scoring of neurological disability and quality of life assessment (QoL). Their previous diagnostic work‐up included clinical examination with scoring of disability, neurophysiological investigation, a battery of serology tests for infections, and cerebrospinal fluid (CSF) examination. Aliquots of CSF were frozen, stored for 20‐28 years, and analyzed by ELISA for determination of neurofilament light protein (NFL) and glial fibrillary acidic protein (GFAP). Results: Patients with poor outcome (n = 3) had significantly higher NFL and GFAP levels at GBS nadir than those with good outcome (n = 15, P < .01 and P < .05, respectively). High NFL correlated with more prominent disability and worse QoL at long‐term follow‐up (r = .694, P < .001, and SF 36 dimension physical component summary (PCS) (r =−.65, P < .05), respectively, whereas GFAP did not correlate with clinical outcome or QoL. Conclusion: High NFL in CSF at the acute stage of GBS seems to predict long‐term outcome and might, together with neurophysiological and clinical measures, be useful in treatment decisions and clinical care of GBS.

Type: Article
Title: Neurofilament light protein levels in cerebrospinal fluid predict long-term disability of Guillain-Barre syndrome: A pilot study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/ane.12927
Publisher version: https://doi.org/10.1111/ane.12927
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: biomarker cerebrospinal fluid glial fibrillary acidic protein Guillain‐Barré syndrome neurofilament light protein prognosis
UCL classification: UCL
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
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/10062798
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