TY - JOUR
T1 - Serum neurofilament light chain predicts long-term prognosis in Guillain-Barré syndrome patients
AU - Martín-Aguilar, Lorena
AU - Camps-Renom, Pol
AU - Lleixà, Cinta
AU - Pascual-Goñi, Elba
AU - Díaz-Manera, Jordi
AU - Rojas-García, Ricardo
AU - De Luna, Noemi
AU - Gallardo, Eduard
AU - Cortés-Vicente, Elena
AU - Muñoz, Laia
AU - Alcolea, Daniel
AU - Lleó, Alberto
AU - Casasnovas, Carlos
AU - Homedes, Christian
AU - Gutiérrez-Gutiérrez, Gerardo
AU - Jimeno-Montero, María Concepción
AU - Berciano, José
AU - Sedano-Tous, María José
AU - García-Sobrino, Tania
AU - Pardo-Fernández, Julio
AU - Márquez-Infante, Celedonio
AU - Rojas-Marcos, Iñigo
AU - Jericó-Pascual, Ivonne
AU - Martínez-Hernández, Eugenia
AU - Morís De La Tassa, Germán
AU - Domínguez-González, Cristina
AU - Illa, Isabel
AU - Querol, Luis
N1 - Funding Information:
Funding This work was supported by Fondo de Investigaciones Sanitarias (FIS), Instituto de Salud Carlos III, Spain and FEDER under grant FIS19/01407, personal grant Rio Hortega CM19/00042, personal grant SLT006/17/00131 of the Pla estratègic de recerca i innovació en salut (PERIS), Departament de Salut, Generalitat de Catalunya, and the ER20P3AC7624 project of the ACCI call of the CIBERER network, Madrid, Spain. AL is supported by Fundació Bancaria La Caixa. DA is supported by Instituto Carlos III under grants PI18/00435 and INT19/00016 and personal grant SLT006/17/125 of the Pla estratègic de recerca i innovació en salut (PERIS).
Publisher Copyright:
© Author(s) (or their employer(s)) 2021.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Objective To study baseline serum neurofilament light chain (sNfL) levels as a prognostic biomarker in Guillain-Barré syndrome (GBS). Methods We measured NfL in serum (98 samples) and cerebrospinal fluid (CSF) (24 samples) of patients with GBS prospectively included in the International GBS Outcome Study (IGOS) in Spain using single-molecule array (SiMoA) and compared them with 53 healthy controls (HCs). We performed multivariable regression to analyse the association between sNfL levels and functional outcome at 1 year. Results Patients with GBS had higher NfL levels than HC in serum (55.49 pg/mL vs 9.83 pg/mL, p<0.0001) and CSF (1308.5 pg/mL vs 440.24 pg/mL, p=0.034). Patients with preceding diarrhoea had higher sNfL than patients with respiratory symptoms or no preceding infection (134.90 pg/mL vs 47.86 pg/mL vs 38.02 pg/mL, p=0.016). sNfL levels correlated with Guillain-Barré Syndrome Disability Score and Inflammatory Rasch-built Overall Disability Scale (I-RODS) at every timepoint. Patients with pure motor variant and Miller Fisher syndrome showed higher sNfL levels than patients with sensorimotor GBS (162.18 pg/mL vs 95.50 pg/mL vs 38.02 pg/mL, p=0.025). Patients with acute motor axonal neuropathy cute motor axonal neuropathy had higher sNfL levels than other variants (190.55 pg/mL vs 46.79 pg/mL, p=0.013). sNfL returned to normal levels at 1 year. High baseline sNfL levels were associated with inability to run (OR=1.65, 95% CI 1.14 to 2.40, p=0.009) and lower I-RODS (β-2.60, 95% CI-4.66 to-0.54, p=0.014) at 1 year. Cut-off points predicting clinically relevant outcomes at 1 year with high specificity were calculated: inability to walk independently (>319 pg/mL), inability to run (>248 pg/mL) and ability to run (<34 pg/mL). Conclusion Baseline sNfL levels are increased in patients with GBS, are associated with disease severity and axonal variants and have an independent prognostic value in patients with GBS.
AB - Objective To study baseline serum neurofilament light chain (sNfL) levels as a prognostic biomarker in Guillain-Barré syndrome (GBS). Methods We measured NfL in serum (98 samples) and cerebrospinal fluid (CSF) (24 samples) of patients with GBS prospectively included in the International GBS Outcome Study (IGOS) in Spain using single-molecule array (SiMoA) and compared them with 53 healthy controls (HCs). We performed multivariable regression to analyse the association between sNfL levels and functional outcome at 1 year. Results Patients with GBS had higher NfL levels than HC in serum (55.49 pg/mL vs 9.83 pg/mL, p<0.0001) and CSF (1308.5 pg/mL vs 440.24 pg/mL, p=0.034). Patients with preceding diarrhoea had higher sNfL than patients with respiratory symptoms or no preceding infection (134.90 pg/mL vs 47.86 pg/mL vs 38.02 pg/mL, p=0.016). sNfL levels correlated with Guillain-Barré Syndrome Disability Score and Inflammatory Rasch-built Overall Disability Scale (I-RODS) at every timepoint. Patients with pure motor variant and Miller Fisher syndrome showed higher sNfL levels than patients with sensorimotor GBS (162.18 pg/mL vs 95.50 pg/mL vs 38.02 pg/mL, p=0.025). Patients with acute motor axonal neuropathy cute motor axonal neuropathy had higher sNfL levels than other variants (190.55 pg/mL vs 46.79 pg/mL, p=0.013). sNfL returned to normal levels at 1 year. High baseline sNfL levels were associated with inability to run (OR=1.65, 95% CI 1.14 to 2.40, p=0.009) and lower I-RODS (β-2.60, 95% CI-4.66 to-0.54, p=0.014) at 1 year. Cut-off points predicting clinically relevant outcomes at 1 year with high specificity were calculated: inability to walk independently (>319 pg/mL), inability to run (>248 pg/mL) and ability to run (<34 pg/mL). Conclusion Baseline sNfL levels are increased in patients with GBS, are associated with disease severity and axonal variants and have an independent prognostic value in patients with GBS.
UR - https://www.scopus.com/pages/publications/85095856927
U2 - 10.1136/jnnp-2020-323899
DO - 10.1136/jnnp-2020-323899
M3 - Article
C2 - 33154183
AN - SCOPUS:85095856927
SN - 0022-3050
VL - 92
SP - 70
EP - 77
JO - Journal of neurology, neurosurgery and psychiatry
JF - Journal of neurology, neurosurgery and psychiatry
IS - 1
ER -
