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Journal of Neurology
Published in: Journal of Neurology 4/2023

Open Access 09-01-2023 | Status Epilepticus | Original Communication

Neurofilament light (NfL) as biomarker in serum and CSF in status epilepticus

Authors: Nils G. Margraf, Justina Dargvainiene, Emily Theel, Frank Leypoldt, Wolfgang Lieb, Andre Franke, Klaus Berger, Jens Kuhle, Gregor Kuhlenbaeumer

Published in: Journal of Neurology | Issue 4/2023

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Abstract

Objective

We explored the potential of neurofilament light chain (NfL) in serum and cerebrospinal fluid as a biomarker for neurodestruction in status epilepticus.

Methods

In a retrospective analysis, we measured NfL in serum and cerebrospinal fluid samples of patients with status epilepticus using a highly sensitive single-molecule array technique (Simoa). Status epilepticus was diagnosed according to ILAE criteria. Additionally, we employed an alternative classification with more emphasis on the course of status epilepticus. We used data from three large control groups to compare NfL in status epilepticus versus neurologically healthy controls.

Results

We included 28 patients (mean age: 69.4 years, SD: 15 years) with a median status duration of 44 h (IQR: 80 h). Twenty-one patients (75%) suffered from convulsive status epilepticus and seven (25%) from non-convulsive status epilepticus. Six patients died (21%). Cerebrospinal fluid and serum NfL concentrations showed a high correlation (r = 0.73, p < 0.001, Pearson). The main determinant of NfL concentration was the status duration. NfL concentrations did not differ between convulsive status epilepticus and convulsive status epilepticus classified according to the ILAE or to the alternative classification without and with adjusting for status duration and time between status onset and sampling. We found no association of NfL concentration with death, treatment refractoriness, or prognostic scores.

Conclusion

The results suggest that neurodestruction in status epilepticus measured by NfL is mainly determined by status duration, not status type nor therapy refractoriness. Therefore, our results suggest that regarding neurodestruction convulsive and non-convulsive status epilepticus are both neurological emergencies of comparable urgency.
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Metadata
Title
Neurofilament light (NfL) as biomarker in serum and CSF in status epilepticus
Authors
Nils G. Margraf
Justina Dargvainiene
Emily Theel
Frank Leypoldt
Wolfgang Lieb
Andre Franke
Klaus Berger
Jens Kuhle
Gregor Kuhlenbaeumer
Publication date
09-01-2023
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 4/2023
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-022-11547-4

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