The Serum Phosphorylated Neurofilament Heavy Subunit as a Predictive Marker for Outcome in Adult Patients after Traumatic Brain Injury

Abstract

The serum phosphorylated neurofilament heavy subunit (pNF-H) is a nervous system-specific protein that is released from damaged neural tissue after traumatic brain injury (TBI). The aim of this study was to elucidate the usefulness of serum pNF-H as a predictive marker for the outcome of patients after TBI. Patients with TBI (Glasgow Coma Scale score of 13 or less on admission) were included. Patients who were younger than age 18, dependent on others for daily activities before injury, pregnant, or who were not likely to survive for more than 24 h after injury were excluded. The outcome was assessed using the Glasgow Outcome Scale at 6 months after injury. Blood was collected from subjects (n = 32), and the serum pNF-H value was assessed at 24 and 72 h after TBI. The optimal cutoff value and usefulness of the serum pNF-H value for predicting the long-term outcome were investigated. We found that the serum pNF-H value at 24 h after injury was a good predictive marker of death at 6 months (p < 0.001) after injury. The optimal cutoff value was 240 pg/mL, and the area under the curve in the receiver operating characteristic analysis was 0.930. The serum pNF-H value at 72 h after injury was correlated with an unfavorable outcome (vegetative state or death) at 6 months (p < 0.01) with a cutoff value of 80 pg/mL. Collectively, the results of this study indicate that the serum pNF-H value is a useful predictive marker for patient outcome after TBI.

Plasma phosphorylated neurofilament heavy chains as a potential marker for ischemic stroke patients

“…Although there is an increasing evidence that NfH could predict severity and evolution in the pathology associated with neuroaxonal damage, there is still not sufficient data that this marker could be used in current practice for evaluation of patients with cerebral ischemia. Besides traumatic brain injury (8,9) and acute intracerebral hemorrhage (10), in the literature there are only a few studies regarding peripheral NfH in ischemic stroke. Traenka et al found that plasma NfL (light chains) concentration correlates with stroke severity mirrored by NIHSS in stroke occurred after cervical artery dissection, and NfL levels significantly associated with poor outcome evaluated after 3 months, but in this study the median time for serum sampling was 6 days, (IQR 3-9.5 days) (11).…”

Correlations between serum and CSF pNfH levels in ALS, FTD and controls: a comparison of three analytical approaches

“…In TBI, serum-pNFH levels at 72h after hospital arrival were significantly higher than at 24h after arrival. Serum-pNFH at 24 hours after injury was shown to be a good predictor of fatal outcome in patients with TBI [148].…”

Diffuse Axonal Injury and Oxidative Stress: A Comprehensive Review

“…NF subunits have been found in the corpus callosum of TBI patients [ 96 ]. A recent study by Shibahashi et al [ 99 ] investigated the usefulness of serum phosphorylated neurofilament heavy subunit (pNF-H) at 24 and 72 h after TBI, as a predictive marker for the outcome (vegetative state or death) of patients at 6 months. Conversely, Neurofilament Light chain (NF-L) protein serum level has been recently advocated as a potentially promising predictor of the 12 months neurological outcome of patients with an MRI demonstrated DAI [ 100 ].…”