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Serum neurofilament light protein predicts clinical outcome in traumatic brain injury.

Research paper by Pashtun P Shahim, Magnus M Gren, Victor V Liman, Ulf U Andreasson, Niklas N Norgren, Yelverton Y Tegner, Niklas N Mattsson, Niels N Andreasen, Martin M Öst, Henrik H Zetterberg, Bengt B Nellgård, Kaj K Blennow

Indexed on: 08 Nov '16Published on: 08 Nov '16Published in: Scientific Reports



Abstract

Axonal white matter injury is believed to be a major determinant of adverse outcomes following traumatic brain injury (TBI). We hypothesized that measurement of neurofilament light protein (NF-L), a protein found in long white-matter axons, in blood samples, may serve as a suitable biomarker for neuronal damage in TBI patients. To test our hypotheses, we designed a study in two parts: i) we developed an immunoassay based on Single molecule array technology for quantification of NF-L in blood, and ii) in a proof-of-concept study, we tested our newly developed method on serial serum samples from severe TBI (sTBI) patients (n = 72) and controls (n = 35). We also compared the diagnostic and prognostic utility of NF-L with the established blood biomarker S100B. NF-L levels were markedly increased in sTBI patients compared with controls. NF-L at admission yielded an AUC of 0.99 to detect TBI versus controls (AUC 0.96 for S100B), and increased to 1.00 at day 12 (0.65 for S100B). Importantly, initial NF-L levels predicted poor 12-month clinical outcome. In contrast, S100B was not related to outcome. Taken together, our data suggests that measurement of serum NF-L may be useful to assess the severity of neuronal injury following sTBI.