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Open Access 01-09-2020 | Syringomyelia | ORIGINAL ARTICLE - SPINE - OTHER

Cerebrospinal fluid levels of GFAP and pNF-H are elevated in patients with chronic spinal cord injury and neurological deterioration

Authors: Ulrika Holmström, Parmenion P. Tsitsopoulos, Anders Holtz, Konstantin Salci, Gerry Shaw, Stefania Mondello, Niklas Marklund

Published in: Acta Neurochirurgica | Issue 9/2020

Abstract

Background

Years after a traumatic spinal cord injury (SCI), a subset of patients may develop progressive clinical deterioration due to intradural scar formation and spinal cord tethering, with or without an associated syringomyelia. Meningitis, intradural hemorrhages, or intradural tumor surgery may also trigger glial scar formation and spinal cord tethering, leading to neurological worsening. Surgery is the treatment of choice in these chronic SCI patients.

Objective

We hypothesized that cerebrospinal fluid (CSF) and plasma biomarkers could track ongoing neuronal loss and scar formation in patients with spinal cord tethering and are associated with clinical symptoms.

Methods

We prospectively enrolled 12 patients with spinal cord tethering and measured glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase L1 (UCH-L1), and phosphorylated Neurofilament-heavy (pNF-H) in CSF and blood. Seven patients with benign lumbar intradural tumors and 7 patients with cervical radiculopathy without spinal cord involvement served as controls.

Results

All evaluated biomarker levels were markedly higher in CSF than in plasma, without any correlation between the two compartments. When compared with radiculopathy controls, CSF GFAP and pNF-H levels were higher in patients with spinal cord tethering (p ≤ 0.05). In contrast, CSF UCH-L1 levels were not altered in chronic SCI patients when compared with either control groups.

Conclusions

The present findings suggest that in patients with spinal cord tethering, CSF GFAP and pNF-H levels might reflect ongoing scar formation and neuronal injury potentially responsible for progressive neurological deterioration.

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Title: Cerebrospinal fluid levels of GFAP and pNF-H are elevated in patients with chronic spinal cord injury and neurological deterioration
Authors: Ulrika Holmström
Parmenion P. Tsitsopoulos
Anders Holtz
Konstantin Salci
Gerry Shaw
Stefania Mondello
Niklas Marklund
Publication date: 01-09-2020
Publisher: Springer Vienna
Keywords: Syringomyelia
Biomarkers
Published in: Acta Neurochirurgica / Issue 9/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-020-04422-6

2024 ASCO Annual Meeting

Springer Medicine

Cerebrospinal fluid levels of GFAP and pNF-H are elevated in patients with chronic spinal cord injury and neurological deterioration

Abstract

Background

Objective

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusions

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