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Serum Neurofilaments Light as a Biomarker of Neurodegeneration in Status Epilepticus

Abstract number : 1.113
Submission category : 2. Translational Research / 2C. Biomarkers
Year : 2021
Submission ID : 1825843
Source : www.aesnet.org
Presentation date : 12/4/2021 12:00:00 PM
Published date : Nov 22, 2021, 06:50 AM

Authors :
Giada Giovannini, MD, PhD student - Unit of Neurology, OCB Hospital, AOU Modena, Italy; PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy; Roberta Bedin, PhD - Department of Biomedical, Metabolic and Neural Sciences; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy; Giulia Turchi, MD - Unit of Neurology, OCB Hospital, AOU Modena, Italy; Niccolò Orlandi, MD - Unit of Neurology, OCB Hospital, AOU Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy; Anna Elisabetta Vaudano, MD - Unit of Neurology, OCB Hospital, AOU Modena, Italy; Diana Ferraro, MD, PhD - Unit of Neurology, OCB Hospital, AOU Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy; Jessica Mandrioli, MD - Unit of Neurology, OCB Hospital, AOU Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy; Stefano Meletti, Prof - Unit of Neurology, OCB Hospital, AOU Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy

Rationale: Neurofilaments (Nf) are members of the family of intermediate filaments specifically expressed in neurons. They maintain the cytoskeleton’ structure of the axons establishing cross-bridging with other filaments. Notably, although Nf have been viewed traditionally as structural components primarily of axons and dendrites, recent evidence has shown that distinctive assemblies of Nf subunits also are integral components of synapses. Nf might be released from damaged or diseased axons in significant amounts into blood and cerebrospinal fluid (CSF). Thus, their elevated levels in either CSF or serum are used as potential biomarkers of neurodegeneration in different neurologic disorders among which Amyotrophic Lateral Sclerosis, Multiple Sclerosis and Fronto-Temporal Dementia. Elevation of serum Neurofilaments Light (sNfL) has been reported in drug resistant epilepsy and, recently, in post-anoxic electrographic status epilepticus.

The rationale of this study is to determine NfL levels in peripheral blood as a biomarker of status epilepticus (SE) severity.

Methods: This is a retrospective, monocentric, cross-sectional study conducted in the OCB Hospital of Modena, Italy. We retrospectively measured the serum NfL concentrations of prospectively collected adult patients with Status Epilepticus (SE) and compared them with epileptic patients (EP) and healthy controls (HC).

Results: 30 patients with SE (mean age 45yrs), 30 patients with epilepsy (mean age 39yrs) and 30 healthy controls (mean age 40yrs) participated in the study. Serum NfL levels were higher in patients with SE (mean: 101.14 pg/ml) compared to epilepsy patients (mean: 8.54 pg/ml) and healthy controls (mean 13.14 pg/ml) (p < 0.001). In patients with SE serum NfL levels showed a high correlation with CSF NfL as well as CSF t-tau levels (p < 0.001). Serum NfL levels were higher in SE lasting > 24 hours (p = 0.013), in refractory SE (p = 0.004), and in patients who died within 30-days or who presented a worsening of clinical conditions (p = 0.001). Serum NfL values above 28.8 pg/ml resulted an independent predictor of 30-days clinical worsening or death (OR 7.78; 95% CI 1.26-48.22; p = 0.027).

Conclusions: serum NfL are increased in SE and correlate with SE treatment response, duration, and outcomes, representing therefore a promising biomarker of seizure-related neuronal damage.

Funding: Please list any funding that was received in support of this abstract.: No funding.

Translational Research