Elevated plasma neurofilament light and glial fibrillary acidic protein in epilepsy versus nonepileptic seizures and nonepileptic disorders

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Elevated plasma neurofilament light and glial fibrillary acidic protein in epilepsy versus nonepileptic seizures and nonepileptic disorders

Dobson, Hannah (författare): Royal Melbourne Hospital,Alfred Health

Al Maawali, Said (författare): Monash University

Malpas, Charles (författare): University of Melbourne

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Santillo, Alexander F. (författare): Lund University,Lunds universitet,Klinisk minnesforskning,Forskargrupper vid Lunds universitet,Lund University Bioimaging Center,Medicinska fakulteten,LU profilområde: Proaktivt åldrande,Lunds universitets profilområden,Clinical Memory Research,Lund University Research Groups,Faculty of Medicine,LU Profile Area: Proactive Ageing,Lund University Profile areas

Kang, Matthew (författare): University of Melbourne,Royal Melbourne Hospital,Alfred Health

Todaro, Marian (författare): Alfred Health,Royal Melbourne Hospital,University of Melbourne,Monash University

Watson, Rosie (författare): Walter and Eliza Hall Institute of Medical Research,University of Melbourne

Yassi, Nawaf (författare): Walter and Eliza Hall Institute of Medical Research,University of Melbourne

Blennow, Kaj, 1958 (författare): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry,Pitié-Salpêtrière University Hospital,Sahlgrenska Academy,Sahlgrenska University Hospital,University of Science and Technology of China

Zetterberg, Henrik, 1973 (författare): Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry,University of Wisconsin-Madison,University College London,Sahlgrenska Academy,Sahlgrenska University Hospital

Foster, Emma (författare): Alfred Health,Monash University

Neal, Andrew (författare): Alfred Health,Monash University

Velakoulis, Dennis (författare): University of Melbourne,Royal Melbourne Hospital

O'Brien, Terence John (författare): Monash University,University of Melbourne

Eratne, Dhamidhu (författare): University of Melbourne,Royal Melbourne Hospital

Kwan, Patrick (författare): University of Melbourne,Monash University,Alfred Health

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(creator_code:org_t)

2024
2024
Engelska.
Ingår i: EPILEPSIA. - 0013-9580 .- 1528-1167.

Relaterad länk:: http://dx.doi.org/10... (free); visa fler...; https://gup.ub.gu.se...; https://doi.org/10.1...; https://lup.lub.lu.s...; visa färre...

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ObjectiveResearch suggests that recurrent seizures may lead to neuronal injury. Neurofilament light chain protein (NfL) and glial fibrillary acidic protein (GFAP) levels increase in cerebrospinal fluid and blood in response to neuroaxonal damage, and they have been hypothesized as potential biomarkers for epilepsy. We examined plasma NfL and GFAP levels and their diagnostic utility in differentiating patients with epilepsy from those with psychogenic nonepileptic seizures (PNES) and other nonepileptic disorders.MethodsWe recruited consecutive adults admitted for video-electroencephalographic monitoring and formal neuropsychiatric assessment. NfL and GFAP levels were quantified and compared between different patient groups and an age-matched reference cohort (n = 1926) and correlated with clinical variables in patients with epilepsy.ResultsA total of 138 patients were included, of whom 104 were diagnosed with epilepsy, 22 with PNES, and 12 with other conditions. Plasma NfL and GFAP levels were elevated in patients with epilepsy compared to PNES, adjusted for age and sex (NfL p = .04, GFAP p = .04). A high proportion of patients with epilepsy (20%) had NfL levels above the 95th age-matched percentile compared to the reference cohort (5%). NfL levels above the 95th percentile of the reference cohort had a 95% positive predictive value for epilepsy. Patients with epilepsy who had NfL levels above the 95th percentile were younger than those with lower levels (37.5 vs. 43.8 years, p = .03).SignificanceAn elevated NfL or GFAP level in an individual patient may support an underlying epilepsy diagnosis, particularly in younger adults, and cautions against a diagnosis of PNES alone. Further examination of the association between NfL and GFAP levels and specific epilepsy subtypes or seizure characteristics may provide valuable insights into disease heterogeneity and contribute to the refinement of diagnosis, understanding pathophysiological mechanisms, and formulating treatment approaches.

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Av författaren/redakt...: Dobson, Hannah; Al Maawali, Said; Malpas, Charles; Santillo, Alexan ...; Kang, Matthew; Todaro, Marian; visa fler...; Watson, Rosie; Yassi, Nawaf; Blennow, Kaj, 19 ...; Zetterberg, Henr ...; Foster, Emma; Neal, Andrew; Velakoulis, Denn ...; O'Brien, Terence ...; Eratne, Dhamidhu; Kwan, Patrick; visa färre...

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Av lärosätet: Göteborgs universitet; Lunds universitet

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Elevated plasma neurofilament light and glial fibrillary acidic protein in epilepsy versus nonepileptic seizures and nonepileptic disorders

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