Evers Katrina S, Hügli Melanie, Fouzas Sotirios, Kasser Severin, Pohl Christian, Stoecklin Benjamin, Bernasconi Luca, Kuhle Jens, Wellmann Sven
Division of Neonatology and University of Basel Children's Hospital (UKBB), Basel, Switzerland.
Paediatric Respiratory Unit and Department of Neonatology, University Hospital of Patras, Patras, Greece.
Front Neurosci. 2020 Sep 29;14:579958. doi: 10.3389/fnins.2020.579958. eCollection 2020.
Neuroaxonal damage is reflected by serum neurofilament light chain (sNfL) values in a variety of acute and degenerative diseases of the brain. The aim of this study was to investigate the impact of febrile and epileptic seizures on sNfL, serum copeptin, and prolactin levels in children compared with children with febrile infections without convulsions.
A prospective cross-sectional study was performed in children aging 6 months to 5 years presenting with fever (controls, = 61), febrile seizures (FS, = 78), or epileptic seizures (ES, = 16) at our emergency department. sNfL, copeptin, and prolactin were measured within a few hours after the event in addition to standard clinical, neurophysiological, and laboratory assessment. All children were followed up for at least 1 year after presentation concerning recurrent seizures.
Serum copeptin values were on average 4.1-fold higher in FS and 3.2-fold higher in ES compared with controls (both < 0.01). Serum prolactin values were on average 1.3-fold higher in FS compared with controls ( < 0.01) and without difference between ES and controls. There was no significant difference of mean sNfL values (95% CI) between all three groups, FS 21.7 pg/ml (19.6-23.9), ES 17.7 pg/ml (13.8-21.6), and controls 23.4 pg/ml (19.2-27.4). In multivariable analysis, age was the most important predictor of sNfL, followed by sex and C reactive protein. Neither the duration of seizures nor the time elapsed from seizure onset to blood sampling had an impact on sNfL. None of the three biomarkers were related to recurrent seizures.
Serum neurofilament light is not elevated during short recovery time after FS when compared with children presenting febrile infections without seizures. We demonstrate an age-dependent decrease of sNfL from early childhood until school age. In contrast to sNfL levels, copeptin and prolactin serum levels are elevated after FS.
在多种急性和退行性脑疾病中，血清神经丝轻链（sNfL）值可反映神经轴突损伤。本研究旨在调查发热性惊厥和癫痫发作对儿童sNfL、血清 copeptin 和催乳素水平的影响，并与无惊厥的发热性感染儿童进行比较。
对在我院急诊科就诊的 6 个月至 5 岁发热儿童（对照组，n = 61）、热性惊厥（FS，n = 78）或癫痫发作（ES，n = 16）进行前瞻性横断面研究。除了标准的临床、神经生理学和实验室评估外，在事件发生后的数小时内测量 sNfL、copeptin 和催乳素。所有儿童在就诊后至少随访 1 年，观察癫痫复发情况。
与对照组相比，FS 组血清 copeptin 值平均高 4.1 倍，ES 组高 3.2 倍（均 P < 0.01）。FS 组血清催乳素值平均比对照组高 1.3 倍（P < 0.01），ES 组与对照组之间无差异。三组的平均 sNfL 值（95%CI）无显著差异，FS 组为 21.7 pg/ml（19.6 - 23.9），ES 组为 17.7 pg/ml（13.8 - 21.6），对照组为 23.4 pg/ml（19.2 - 27.4）。在多变量分析中，年龄是 sNfL 的最重要预测因素，其次是性别和 C 反应蛋白。癫痫发作持续时间和从发作开始到采血的时间均对 sNfL 无影响。这三种生物标志物均与癫痫复发无关。
与无惊厥的发热性感染儿童相比，FS 后短时间恢复期间血清神经丝轻链未升高。我们证明了从幼儿期到学龄期 sNfL 呈年龄依赖性下降。与 sNfL 水平相反，FS 后 copeptin 和催乳素血清水平升高。
