Giovannini Giada, Bedin Roberta, Orlandi Niccolò, Turchi Giulia, Cioclu Maria Cristina, Biagioli Niccolò, Madrassi Laura, Pugnaghi Matteo, Vaudano Anna Elisabetta, Meletti Stefano
Unit of Neurology, OCB Hospital, AOU Modena, Italy; PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy.
Department of Biomedical, Metabolic and Neural Sciences; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy.
Epilepsy Behav. 2023 Mar;140:109131. doi: 10.1016/j.yebeh.2023.109131. Epub 2023 Feb 11.
The last ILAE definition of Status Epilepticus (SE) highlights that the persistence of the epileptic activity per se could determine irreversible brain damages that could be responsible for long-term consequences. The measurement of neuro-glial injury biomarkers could help in the identification of those patients who will eventually develop short- and long-term consequences of SE. At present none of the already studied biomarkers has been validated to be used in everyday clinical practice. In this study, we explore the role of NfL and S100B as a prognostic biomarkers to identify patients who will develop short-term disability after an episode of SE.
This is a retrospective assessment of the serum levels of both NfL and S100B in a cohort of 87 adult patients with SE prospectively collected in our SE registry (Modena Status Epilepticus Registry - MoSER -) at Baggiovara Civil Hospital (Modena, Italy). All samples were acquired during SE within 72 hours of SE diagnosis. The comparison groups were: healthy controls (HC, n = 27) and patients with epilepsy (PWE, n = 30). Demographic, clinical, and therapeutical information and thirty-days follow-up information regarding disability development were acquired for every included patient and analyzed in relation to NfL and S100B values.
Serum levels of NfL were significantly higher in SE compared to those of PWE (median 7.35 pg/ml, IQR 6.4, p < 0.001) and HC (median 6.57 pg/ml, IQR 9.1, p < 0.001); S100B serum levels were higher in SE (median 0.11 ug/L, IQR 0.18) compared to PWE (median 0.03 ug/L, IQR 0.03, p < 0.001) and HC (median 0.02 ug/L, IQR 0.008, p < 0.001). However, only NfL serum levels were found to be an independent predictor of 30 days functional outcome whereas S100B levels did not.
Our results suggest that NfL measurement in serum during SE could help predict the short-term functional outcome. This paper was presented at the 8th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in September 2022.
国际抗癫痫联盟（ILAE）对癫痫持续状态（SE）的最新定义强调，癫痫活动本身的持续存在可能会导致不可逆的脑损伤，进而引发长期后果。神经胶质损伤生物标志物的检测有助于识别那些最终会出现SE短期和长期后果的患者。目前，尚未有已研究的生物标志物被验证可用于日常临床实践。在本研究中，我们探讨了神经丝轻链（NfL）和S100B作为预后生物标志物的作用，以识别在SE发作后会出现短期残疾的患者。
这是一项对87例成年SE患者血清中NfL和S100B水平的回顾性评估，这些患者是前瞻性收集于我们在意大利摩德纳巴焦瓦拉市立医院的SE登记册（摩德纳癫痫持续状态登记册-MoSER-）中的。所有样本均在SE诊断后72小时内的SE期间采集。比较组为：健康对照（HC，n = 27）和癫痫患者（PWE，n = 30）。收集了每位纳入患者的人口统计学、临床和治疗信息以及关于残疾发展的30天随访信息，并根据NfL和S100B值进行分析。
与PWE（中位数7.35 pg/ml，四分位间距6.4，p < 0.001）和HC（中位数6.57 pg/ml，四分位间距9.1，p < 0.001）相比，SE患者血清中的NfL水平显著更高；与PWE（中位数0.03 μg/L，四分位间距0.03，p < 0.001）和HC（中位数0.02 μg/L，四分位间距0.008，p < 0.001）相比，SE患者的S100B血清水平更高（中位数0.11 μg/L，四分位间距0.18）。然而，仅发现NfL血清水平是30天功能结局的独立预测指标，而S100B水平并非如此。
我们的结果表明，在SE期间检测血清中的NfL有助于预测短期功能结局。本文在2022年9月举行的第8届伦敦 - 因斯布鲁克癫痫持续状态和急性癫痫发作学术研讨会上发表。
