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Hossain I, Mohammadian M, Maanpää HR, Takala RSK, Tenovuo O, van Gils M, Hutchinson P, Menon DK, Newcombe VF, Tallus J, Hirvonen J, Roine T, Kurki T, Blennow K, Zetterberg H, Posti JP. Plasma neurofilament light admission levels and development of axonal pathology in mild traumatic brain injury. BMC Neurol 2023; 23:304. [PMID: 37582732 PMCID: PMC10426141 DOI: 10.1186/s12883-023-03284-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 06/10/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND It is known that blood levels of neurofilament light (NF-L) and diffusion-weighted magnetic resonance imaging (DW-MRI) are both associated with outcome of patients with mild traumatic brain injury (mTBI). Here, we sought to examine the association between admission levels of plasma NF-L and white matter (WM) integrity in post-acute stage DW-MRI in patients with mTBI. METHODS Ninety-three patients with mTBI (GCS ≥ 13), blood sample for NF-L within 24 h of admission, and DW-MRI ≥ 90 days post-injury (median = 229) were included. Mean fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were calculated from the skeletonized WM tracts of the whole brain. Outcome was assessed using the Extended Glasgow Outcome Scale (GOSE) at the time of imaging. Patients were divided into CT-positive and -negative, and complete (GOSE = 8) and incomplete recovery (GOSE < 8) groups. RESULTS The levels of NF-L and FA correlated negatively in the whole cohort (p = 0.002), in CT-positive patients (p = 0.016), and in those with incomplete recovery (p = 0.005). The same groups showed a positive correlation with mean MD, AD, and RD (p < 0.001-p = 0.011). In CT-negative patients or in patients with full recovery, significant correlations were not found. CONCLUSION In patients with mTBI, the significant correlation between NF-L levels at admission and diffusion tensor imaging (DTI) measurements of diffuse axonal injury (DAI) over more than 3 months suggests that the early levels of plasma NF-L may associate with the presence of DAI at a later phase of TBI.
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Affiliation(s)
- Iftakher Hossain
- Department of Neurosurgery, Neurocenter, Turku University Hospital, Turku, Finland.
- Turku Brain Injury Center, Turku University Hospital, Turku, Finland.
- Department of Clinical Neurosciences, University of Turku, Turku, Finland.
- Department of Clinical Neurosciences, Neurosurgery Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
| | - Mehrbod Mohammadian
- Turku Brain Injury Center, Turku University Hospital, Turku, Finland
- Department of Clinical Neurosciences, University of Turku, Turku, Finland
| | - Henna-Riikka Maanpää
- Department of Neurosurgery, Neurocenter, Turku University Hospital, Turku, Finland
- Turku Brain Injury Center, Turku University Hospital, Turku, Finland
- Department of Clinical Neurosciences, University of Turku, Turku, Finland
| | - Riikka S K Takala
- Intensive Care Medicine and Pain Management, Perioperative Services, Turku University Hospital and University of Turku, Turku, Finland
| | - Olli Tenovuo
- Department of Clinical Neurosciences, University of Turku, Turku, Finland
| | - Mark van Gils
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Peter Hutchinson
- Department of Clinical Neurosciences, Neurosurgery Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - David K Menon
- Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Virginia F Newcombe
- Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Jussi Tallus
- Turku Brain Injury Center, Turku University Hospital, Turku, Finland
- Department of Clinical Neurosciences, University of Turku, Turku, Finland
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Jussi Hirvonen
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Timo Roine
- Turku Brain and Mind Center, University of Turku, Turku, Finland
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Turku, Finland
| | - Timo Kurki
- Turku Brain Injury Center, Turku University Hospital, Turku, Finland
- Department of Clinical Neurosciences, University of Turku, Turku, Finland
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, University College London, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Jussi P Posti
- Department of Neurosurgery, Neurocenter, Turku University Hospital, Turku, Finland
- Turku Brain Injury Center, Turku University Hospital, Turku, Finland
- Department of Clinical Neurosciences, University of Turku, Turku, Finland
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