Tullberg M, Rosengren L, Blomsterwall E, Karlsson J E, Wikkelsö C
Institution of Clinical Neuroscience, University of Göteborg, Sweden.
Neurology. 1998 Apr;50(4):1122-7. doi: 10.1212/wnl.50.4.1122.
We examined CSF levels of markers of neuronal degeneration and astrogliosis-the light subunit of the neurofilament triplet protein (NFL) and the glial fibrillary acidic protein (GFAP)-in 65 patients with normal pressure hydrocephalus (NPH). NFL was increased sixfold (864 +/- 1,538 [mean +/- SD] versus 156 +/- 81 ng/L; p < or = 0.001) and GFAP twofold (1,116 +/- 1,085 versus 637 +/- 295 ng/L; p < or = 0.01) in NPH patients compared with neurologically healthy age-matched controls. No correlation was found between any particular symptom or sign and GFAP levels in CSF. The levels of NFL, on the other hand, were higher in patients with severe symptoms compared with those with moderate or no symptoms. Furthermore, there was a correlation between a high level of NFL and gait disturbance, incontinence, psychometric incapability, and social dysfunction. A high preoperative NFL level was associated with favorable outcome after shunt surgery. This indicates that NFL is a marker of ongoing and possibly still-reversible axonal damage in NPH.
我们检测了65例正常压力脑积水（NPH）患者脑脊液中神经元变性和星形胶质细胞增生标志物的水平，即神经丝三联蛋白的轻链亚基（NFL）和胶质纤维酸性蛋白（GFAP）。与年龄匹配的神经功能正常的对照组相比，NPH患者的NFL升高了6倍（864±1538[平均值±标准差]对156±81 ng/L；p≤0.001），GFAP升高了2倍（1116±1085对637±295 ng/L；p≤0.01）。脑脊液中任何特定症状或体征与GFAP水平之间均未发现相关性。另一方面，与中度或无症状患者相比，重度症状患者的NFL水平更高。此外，高水平的NFL与步态障碍、尿失禁、心理功能障碍和社会功能障碍之间存在相关性。术前NFL水平高与分流手术后良好的预后相关。这表明NFL是NPH中正在进行且可能仍可逆的轴突损伤的标志物。
