Sustained Axonal Degeneration in Prolonged Disorders of Consciousness

Brain Sciences

Serena Gennaro¹  Antonio De Tanti¹  Teresa Barone²  Maria Enza D’Ippolito³  Maria Andriolo³  Valentina Colombo⁴  Pamela Salucci⁴  Valeria Pingue⁵  Antonio Nardone⁵  Maria Ursino⁶  Lucia Francesca Lucca⁶  Francesca Rubino⁷  Teresa Fiorilla⁷  Sergio Bagnato⁷  Cristina Boccagni⁷ 

[1] Cardinal Ferrari Center, 43012 Fontanellato, Italy;Immunohematology and Transfusion Service, 90015 Cefalù, Italy;Molecular Biology Laboratory, Giuseppe Giglio Foundation, 90015 Cefalù, Italy;Montecatone Rehabilitation Institute, 40026 Imola, Italy;Neurorehabilitation and Spinal Units, ICS Maugeri, Institute of Pavia, 27100 Pavia, Italy;RAN (Research in Advanced Neuro-Rehabilitation), S. Anna Institute, 88900 Crotone, Italy;Unit of Neurophysiology and Unit for Severe Acquired Brain Injuries, Rehabilitation Department, Giuseppe Giglio Foundation, 90015 Cefalù, Italy;

关键词: neurofilament light chain;    traumatic brain injury;    hypoxic-ischemic brain injury;    unresponsive wakefulness syndrome;    vegetative state;    minimally conscious state;   

DOI  :  10.3390/brainsci11081068

来源: DOAJ

【 摘 要 】

(1) Background: Sustained axonal degeneration may play a critical role in prolonged disorder of consciousness (DOCs) pathophysiology. We evaluated levels of neurofilament light chain (NFL), an axonal injury marker, in patients with unresponsive wakefulness syndrome (UWS) and in the minimally conscious state (MCS) after traumatic brain injury (TBI) and hypoxic-ischemic brain injury (HIBI). (2) Methods: This prospective multicenter blinded study involved 70 patients with prolonged DOC and 70 sex-/age-matched healthy controls. Serum NFL levels were evaluated at 1–3 and 6 months post-injury and compared with those of controls. NFL levels were compared by DOC severity (UWS vs. MCS) and etiology (TBI vs. HIBI). (3) Results: Patients’ serum NFL levels were significantly higher than those of controls at 1–3 and 6 months post-injury (medians, 1729 and 426 vs. 90 pg/mL; both p < 0.0001). NFL levels were higher in patients with UWS than in those in MCS at 1–3 months post-injury (p = 0.008) and in patients with HIBI than in those with TBI at 6 months post-injury (p = 0.037). (4) Conclusions: Patients with prolonged DOC present sustained axonal degeneration that is affected differently over time by brain injury severity and etiology.

【 授权许可】

Unknown