Frank Anika, Arjomand Jonas, Bendig Jonas, Delfs Mia, Klingelhoefer Lisa, Polanski Witold H, Akgün Katja, Ziemssen Tjalf, Falkenburger Björn, Schnalke Nils
Department of Neurology, University Hospital Carl Gustav Carus Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Center for Neurodegenerative Diseases within the Helmholtz Association (DZNE), Dresden, Germany.
Sci Rep. 2025 May 13;15(1):16537. doi: 10.1038/s41598-025-00399-3.
Deep brain stimulation (DBS) is an efficient treatment for movement disorders, most commonly Parkinson's Disease (PD), dystonia and essential tremor. DBS surgery carries risks, e.g. the risk of delayed peri-lead edema (PLE) and the risk of postoperative cognitive decline. The mechanisms of these complications are not fully understood and there is no established biomarker to screen for these complications after DBS surgery. To explore the diagnostic value of two blood-based markers representative for distinct types of brain injury, we characterized the dynamics of serum glial fibrillary acidic protein (sGFAP, for glial injury) and serum neurofilament light chain (sNfL, for neuronal-axonal injury) following DBS surgery. We analyzed longitudinal dynamics of serum protein levels in 58 patients undergoing deep brain stimulation (DBS) at our center for half a year post-surgery. Serum GFAP responded much more rapidly after brain surgery, returning to baseline after weeks, whereas sNfL only returned to baseline after months. Patients with lower preoperative cognitive performance exhibited higher postoperative sGFAP levels, with sGFAP showing a stronger association with preoperative patient characteristics compared to sNfL. Further studies with long-term clinical follow-up are needed to fully evaluate the utility of sGFAP as a biomarker for both early and delayed complications after DBS surgery, including cognitive decline and potential foreign body reactions to the implanted lead.
深部脑刺激（DBS）是治疗运动障碍的一种有效方法，最常用于治疗帕金森病（PD）、肌张力障碍和特发性震颤。DBS手术存在风险，例如迟发性电极周围水肿（PLE）风险和术后认知功能下降风险。这些并发症的机制尚未完全明确，且在DBS手术后尚无已确立的生物标志物来筛查这些并发症。为了探究两种代表不同类型脑损伤的血液标志物的诊断价值，我们对DBS手术后血清胶质纤维酸性蛋白（sGFAP，用于评估胶质损伤）和血清神经丝轻链（sNfL，用于评估神经元轴突损伤）的动态变化进行了表征。我们分析了在我们中心接受深部脑刺激（DBS）手术的58例患者术后半年内血清蛋白水平的纵向动态变化。脑手术后血清GFAP反应更快，数周后恢复至基线水平，而sNfL数月后才恢复至基线水平。术前认知功能较差的患者术后sGFAP水平较高，与sNfL相比，sGFAP与术前患者特征的关联更强。需要进行长期临床随访的进一步研究，以全面评估sGFAP作为DBS手术后早期和迟发性并发症（包括认知功能下降和对植入电极的潜在异物反应）生物标志物的效用。
