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The current study aimed to evaluate whether cerebrospinal fluid (CSF) neuron-specific enolase (NSE) levels are elevated in amyotrophic lateral sclerosis (ALS) and are effective in distinguishing ALS from cervical spondylotic myelopathy (CSM). We retrospectively evaluated 45 patients with ALS, 23 with CSM, 28 controls, and 10 with Parkinson's disease (PD) who underwent analysis of CSF NSE levels. The control group comprised patients aged above 45 years who underwent lumbar puncture because of suspected neurological disorders that were ruled out after extensive investigations. CSF NSE levels were evaluated using the electro-chemiluminescent immunoassay. The ALS group had significantly higher CSF NSE levels than the CSM and control groups (P < 0.001 for both comparisons). The CSM, control, and PD groups did not significantly differ in terms of CSF NSE levels. A receiver-operating characteristic curve analysis was performed to assess the diagnostic value of CSF NSE levels in distinguishing ALS from CSM. The area under the curve for CSF NSE levels was 0.86. The optimal cutoff value was 17.7 ng/mL, with a specificity of 87% and a sensitivity of 80%. Hence, CSF NSE levels are elevated in ALS and are effective in distinguishing ALS from CSM.

Neuron-specific enolase level is a useful biomarker for distinguishing amyotrophic lateral sclerosis from cervical spondylotic myelopathy.

机构信息

Division of Neurology, Department of Internal Medicine IV, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.

Department of Medical Statistics, Research and Development Center, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.

出版信息

Sci Rep. 2021 Nov 24;11(1):22827. doi: 10.1038/s41598-021-02310-2.

本研究旨在评估脑脊液（CSF）神经元特异性烯醇化酶（NSE）水平在肌萎缩侧索硬化症（ALS）中的升高情况，以及其在区分 ALS 与颈椎病脊髓病（CSM）方面的有效性。我们回顾性评估了 45 例 ALS 患者、23 例 CSM 患者、28 例对照患者和 10 例帕金森病（PD）患者的 CSF NSE 水平。对照组为年龄在 45 岁以上的患者，因疑似神经疾病而行腰椎穿刺，经广泛检查排除后纳入。使用电化学发光免疫分析评估 CSF NSE 水平。ALS 组的 CSF NSE 水平明显高于 CSM 组和对照组（两者比较 P<0.001）。CSM 组、对照组和 PD 组的 CSF NSE 水平无显著差异。进行了受试者工作特征曲线分析以评估 CSF NSE 水平在区分 ALS 和 CSM 方面的诊断价值。CSF NSE 水平的曲线下面积为 0.86。最佳截断值为 17.7ng/mL，特异性为 87%，敏感性为 80%。因此，CSF NSE 水平在 ALS 中升高，并能有效区分 ALS 与 CSM。