Rabon William, Rode Megan, Taylor Tavis, Muluk Pallavi, Krishnamoorthy Aparna, Easow Hannah, Stout Gabreille, Chang Yue-Fang, Hamilton D Kojo, Thirumala Parthasarathy D, Agarwal Nitin
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
World Neurosurg. 2025 Mar;195:123515. doi: 10.1016/j.wneu.2024.11.098. Epub 2024 Dec 12.
Acute traumatic spinal cord injury (SCI) results in a lifelong condition without any standardized biomarker or corresponding interventions. The objective of this study was to correlate changes in fluid biomarkers with the severity of SCI.
The test model used forces of 100 and 200 kdyn. Both of these severities have been established for acute SCI models. Motor evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs) and Basso, Beattie, and Bresnahan (BBB) scores were recorded at both levels of force at various timepoints from before injury to up to 72 hours after SCI. Serum levels for neurofilament heavy chain (NfH) and light chain (NfL) biomarker concentrations were collected at the same timepoints as well.
An expected decrease in the amplitude of MEPs and SSEPs was observed following impact, with signals from the 200 kdyn group exhibiting a greater decline. Likewise, BBB scores showing locomotion also decreased post-SCI. Concentrations of the neurofilaments greatly increased post-SCI. In the 100 kdyn group, a statistically significant negative correlation was found between the BBB score and NfH concentration. In the 200 kdyn injury group, a negative trend was found between the neurofilaments and BBB scores.
A negative correlation was observed between biomarkers and functional outcome scores with statistical significance for the 100 kdyn injury. As such, this study demonstrates the potential usefulness of these biomarkers in SCI, especially with regard to impact severity. Futures studies may be conducted at various impact forces to establish a biomarker gradient based on severity of injury.
急性创伤性脊髓损伤（SCI）会导致终身残疾，且尚无任何标准化的生物标志物或相应的干预措施。本研究的目的是将体液生物标志物的变化与SCI的严重程度相关联。
测试模型使用100和200千达因的力。这两种严重程度均已在急性SCI模型中得到确立。在从损伤前到SCI后72小时的不同时间点，记录了这两种力水平下的运动诱发电位（MEP）、体感诱发电位（SSEP）以及Basso、Beattie和Bresnahan（BBB）评分。同时还在相同时间点收集了血清中神经丝重链（NfH）和轻链（NfL）生物标志物的浓度。
撞击后观察到MEP和SSEP的幅度出现预期下降，200千达因组的信号下降幅度更大。同样，显示运动能力的BBB评分在SCI后也下降了。SCI后神经丝浓度大幅增加。在100千达因组中，发现BBB评分与NfH浓度之间存在统计学上显著的负相关。在200千达因损伤组中，神经丝与BBB评分之间呈现负相关趋势。
观察到生物标志物与功能结局评分之间存在负相关，对于100千达因损伤具有统计学意义。因此，本研究证明了这些生物标志物在SCI中的潜在用途，尤其是在撞击严重程度方面。未来的研究可以在不同的撞击力下进行，以根据损伤严重程度建立生物标志物梯度。
