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. 2021 Apr;268(4):1323-1329.
doi: 10.1007/s00415-020-10277-9. Epub 2020 Oct 23.

Serum neurofilament light chain as outcome marker for intensive care unit patients

Anna Lena Fisse #  1 , Kalliopi Pitarokoili #  2 , David Leppert  3 , Jeremias Motte  2 , Xiomara Pedreiturria  2 , Ludwig Kappos  3 , Ralf Gold  2 , Jens Kuhle #  3 , Min-Suk Yoon #  4
Affiliations

Serum neurofilament light chain as outcome marker for intensive care unit patients

Anna Lena Fisse et al. J Neurol. 2021 Apr.

Abstract

Objective: Neurofilament light chain (NfL) in serum indicates neuro-axonal damage in diseases of the central and peripheral nervous system. Reliable markers to enable early estimation of clinical outcome of intensive care unit (ICU) patients are lacking. The aim of this study was to investigate, whether serum NfL levels are a possible biomarker for prediction of outcome of ICU patients.

Methods: Thirty five patients were prospectively examined from admission to ICU until discharge from the hospital or death. NfL levels were measured longitudinally by a Simoa assay.

Results: NfL was elevated in all ICU patients and reached its maximum at day 35 of ICU treatment. Outcome determined by modified Rankin Scale at the end of the follow-up period correlated with NfL level at admission, especially in the group of patients with impairment of the central nervous system (n = 25, r = 0.56, p = 0.02).

Conclusion: NfL could be used as a prognostic marker for outcome of ICU patients, especially in patients with impairment of the central nervous system.

Keywords: Critical illness polyneuromyopathy; Intensive care unit; Neurofilament; Outcome.

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Conflict of interest statement

Anna Lena Fisse: received honoraria and travel grants from Novartis AG, Sanofi and Eisai GmbH, none related to this work. Owns shares of Fresenius SE & Co., Gilead Sciences, Medtronic PLC and Novartis AG. Kalliopi Pitarokoili: received travel grants and speakers’ honoraria from Novartis, Biogen idec, Teva, Bayer Schering, CSL Behring, Celgene and Grifols all not related to the manuscript. David Leppert: none related to this work. Jeremias Motte: received travel grants from Biogen idec, Novartis AG, Teva and Eisai GmbH, his research is funded by Klaus Tschira Foundation and Ruhr-University, Bochum (FoRUM-program); none related to this work. Xiomara Pedreiturria: none related to this work. Ludwig Kappos: none related to this work. Ralf Gold: received consultation fees and speaker honoraria from Bayer Schering, Biogen idec, Merck Serono, Novartis, Sanofi-Aventis and TEVA. He also acknowledges grant support from Bayer Schering, Biogen idec, Merck Serono, Sanofi-Aventis and TEVA, none related to this manuscript. Min-Suk Yoon: received speakers’ honoraria from CSL Behring, Grifols and scientific grant from CSL Behring. Jens Kuhle: received speaker fees, research support, travel support, and/or served on advisory boards by ECTRIMS, Swiss MS Society, Swiss National Research Foundation (320030_189140/1), University of Basel, Bayer, Biogen, Genzyme, Merck, Novartis, Protagen AG, Roche, Teva.

Figures

Fig. 1
Fig. 1
Correlation between NfL at admission and outcome mRS at end of follow-up in the whole study group (r = 0.58, p = 0.05)
Fig. 2
Fig. 2
NfL course during ICU stay shown as log10 of median. Highest NfL levels were found on day 35
Fig. 3
Fig. 3
NfL levels in patients with and without CNS disease
See this image and copyright information in PMC

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