Top

Acta Neurologica Belgica

Published in:

19-07-2023 | Intoxication | Original article

Serum neurofilament light chain for predicting delayed neurological sequelae after acute carbon monoxide poisoning

Authors: Xue Zheng Liang, Shun Yi Feng

Published in: Acta Neurologica Belgica | Issue 1/2024

Abstract

Introduction

Acute carbon monoxide (CO) poisoning survivors may experience persistent delayed neurological sequelae (DNS). No studies have investigated the serum neurofilament light chain (NFL) as a prognostic biomarker in acute CO poisoning. This study aimed to determine the serum NFL levels to predict the DNS after acute CO poisoning.

Methods

Patients with acute CO poisoning who were consecutively admitted from October 2020 to September 2022 were included. The predictive performance of NFLs for the DNS was assessed through the analyses of the correlation, the logistic regression, and the receiver operating characteristic (ROC) curve.

Results

Overall, 9.7% (15/155) of the patients had DNS. The serum NFLs in patients with DNS was 113.7 pg/mL, which is significantly higher than that in the non-DNS group (25.8 pg/mL; P < 0.001). Correlation analysis shows that the serum NFLs are positively correlated with DNS (r = 0.567, P < 0.001). After multiple adjustments, the serum NFLs are independently correlated with DNS [adjusted odds ratio 1.032; 95% confidence interval (CI) 1.001, 1.064; p = 0.043]. The ROC curve indicates an area under the curve (AUC) of 0.923 (95% CI 0.869, 0.960), with a sensitivity of 100% and a specificity of 84.3% at the best cutoff value of 73.4 pg/mL. Pairwise comparison shows that the AUC of the NFL is significantly higher than that of the neuron specific enolase (AUC = 0.779) using the Hanley and McNeil test (Z = 2.283, p = 0.022).

Conclusion

Serum NFL could be a biomarker of the DNS after acute CO poisoning.

Adler C, Onur OA, Braumann S, Gramespacher H, Bittner S, Falk S et al (2022) Absolute serum neurofilament light chain levels and its early kinetics predict brain injury after out-of-hospital cardiac arrest. J Neurol 269(3):1530–1537CrossRefPubMed

Beppu T (2014) The role of MR imaging in assessment of brain damage from carbon monoxide poisoning: a review of the literature. AJNR Am J Neuroradiol 35(4):625–631CrossRefPubMedPubMedCentral

Chen W, Wang G, Yao C, Zhu Z, Chen R, Su W et al (2022) The ratio of serum neuron-specific enolase level to admission Glasgow Coma Scale Score is associated with diffuse axonal injury in patients with moderate to severe traumatic brain injury. Front Neurol 13:887818CrossRefPubMedPubMedCentral

Disanto G, Prosperetti C, Gobbi C, Barro C, Michalak Z, Cassina T et al (2019) Serum neurofilament light chain as a prognostic marker in postanoxic encephalopathy. Epilepsy Behav 101(Pt B):106432CrossRefPubMed

Geisen U, Benk C, Beyersdorf F, Klemm R, Trummer G, Özbek B et al (2015) Neuron-specific enolase correlates to laboratory markers of haemolysis in patients on long-term circulatory support. Eur J Cardiothorac Surg 48(3):416–420CrossRefPubMed

González-Quevedo A, González-García S, Hernández-Díaz Z, Fernández Concepción O, Quevedo Sotolongo L, Peña-Sánchez M et al (2016) Serum neuron specific enolase could predict subclinical brain damage and the subsequent occurrence of brain related vascular events during follow up in essential hypertension. J Neurol Sci 363:158–163CrossRefPubMed

Huang YQ, Peng ZR, Huang FL, Yang AL (2020) Mechanism of delayed encephalopathy after acute carbon monoxide poisoning. Neural Regen Res 15(12):2286–2295CrossRefPubMedPubMedCentral

Jakimovski D, Dwyer MG, Bergsland N, Weinstock-Guttman B, Zivadinov R (2021) Disease biomarkers in multiple sclerosis: current serum neurofilament light chain perspectives. Neurodegener Dis Manag 11(4):329–340CrossRefPubMed

Kim HB, Nah S, Choi SW, Kim GW, Lee YH, Moon JE et al (2022) Objective predictors of delayed neurological sequelae in patients with altered mental status after carbon monoxide poisoning. Undersea Hyperb Med 49(1):83–91CrossRefPubMed

10.

Kouchaki E, Dashti F, Mirazimi SMA, Alirezaei Z, Jafari SH, Hamblin MR et al (2021) Neurofilament light chain as a biomarker for diagnosis of multiple sclerosis. Excli J 20:1308–1325PubMedPubMedCentral

11.

Liu S, Liu Y, Yang C, Xie D, Zhang X (2022) Charcoal burning is associated with a higher risk of delayed neurological sequelae after domestic carbon monoxide poisoning in South China: a retrospective cohort study. Am J Emerg Med 60:57–61CrossRefPubMed

12.

Lv Y, Zhang Y, Pan S (2021) Brain stem and spinal cord demyelination due to acute carbon monoxide poisoning. Undersea Hyperb Med 48(3):247–253CrossRefPubMed

13.

Martani L, Giovanniello A, Bosco G, Cantadori L, Calissi F, Furfaro D et al (2022) Delayed neurological sequelae successfully treated with adjuvant, prolonged hyperbaric oxygen therapy: review and case report. Int J Environ Res Public Health 19(9):5300CrossRefPubMedPubMedCentral

14.

Mortensen C, Steffensen KD, Simonsen E, Herskind K, Madsen JS, Olsen DA et al (2023) Neurofilament light chain as a biomarker of axonal damage in sensory neurons and paclitaxel-induced peripheral neuropathy in ovarian cancer patients. Pain 164(7):1502–1511CrossRefPubMed

15.

Pujol-Calderón F, Portelius E, Zetterberg H, Blennow K, Rosengren LE, Höglund K (2019) Neurofilament changes in serum and cerebrospinal fluid after acute ischemic stroke. Neurosci Lett 698:58–63CrossRefPubMed

16.

Rana OR, Schröder JW, Baukloh JK, Saygili E, Mischke K, Schiefer J et al (2013) Neurofilament light chain as an early and sensitive predictor of long-term neurological outcome in patients after cardiac arrest. Int J Cardiol 168(2):1322–1327CrossRefPubMed

17.

Sert ET, Kokulu K, Mutlu H (2021) Clinical predictors of delayed neurological sequelae in charcoal-burning carbon monoxide poisoning. Am J Emerg Med 48:12–17CrossRefPubMed

18.

Thebault S, Booth RA, Freedman MS (2020) Blood neurofilament light chain: the neurologist’s troponin? Biomedicines 8(11):523CrossRefPubMedPubMedCentral

19.

Thelin EP, Zeiler FA, Ercole A, Mondello S, Büki A, Bellander BM et al (2017) Serial sampling of serum protein biomarkers for monitoring human traumatic brain injury dynamics: a systematic review. Front Neurol 8:300CrossRefPubMedPubMedCentral

20.

Wang T, Zhang Y, Gu Y, Chen J, Lei J, Guo S (2022) Neurological sequelae in acute carbon monoxide poisoning: a prospective observational study with MRI data. Acta Neurol Scand 145(5):590–598CrossRefPubMed

21.

Weaver LK, Howe S, Hopkins R, Chan KJ (2000) Carboxyhemoglobin half-life in carbon monoxide-poisoned patients treated with 100% oxygen at atmospheric pressure. Chest 117(3):801–808CrossRefPubMed

22.

Ye W, Tang Y, Dong X, Chen G, Yan Y, Zhou L et al (2020) Predictive value and correlation of neuron-specific enolase for prognosis in patients with coma: a systematic review and meta-analysis. Eur Neurol 83(6):555–565CrossRefPubMed

23.

Ziemssen T, Akgun K, Członkowska A, Antos A, Bembenek J, Kurkowska-Jastrzębska I et al (2022) Serum neurofilament light chain as a biomarker of brain injury in Wilson’s disease: clinical and neuroradiological correlations. Mov Disord 37(5):1074–1079CrossRefPubMed

Title: Serum neurofilament light chain for predicting delayed neurological sequelae after acute carbon monoxide poisoning
Authors: Xue Zheng Liang
Shun Yi Feng
Publication date: 19-07-2023
Publisher: Springer International Publishing
Keywords: Intoxication
Coma
Published in: Acta Neurologica Belgica / Issue 1/2024
Print ISSN: 0300-9009
Electronic ISSN: 2240-2993
DOI: https://doi.org/10.1007/s13760-023-02334-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Serum neurofilament light chain for predicting delayed neurological sequelae after acute carbon monoxide poisoning

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2024

Correspondence on COVID-19 vaccination uptake in people with multiple sclerosis

The utility of heart-type free fatty-acid binding-protein (HFABP) levels for differentiating acute ischemic stroke from stroke mimics

Post-stroke corneal and facial ulcerations: trigeminal trophic syndrome

Comparison of the effects of rhythmic vibrotactile stimulations and rhythmic auditory stimulations on Parkinson's disease patients’ gait variability: a pilot study

Association between MEF2 family gene polymorphisms and susceptibility to multiple sclerosis in Chinese population

Holospinal epidural abscess with multiple muscle abscesses and aortic valve endocarditis: case report