Abstract
Introduction
Neurofilament light chains (NfL) have been reported as potential markers for neuronal-axonal injury in neuroinflammatory diseases. In the current study, we describe serum NfL levels as a prognostic marker for anti-N-methyl-D-aspartate receptor encephalitis (NMDARE).
Methods
Serum levels of NfL of 64 patients with anti-NMDARE and 84 healthy controls were measured by Simoa. The anti-NMDAR Encephalitis One-Year Functional Status (NEOS) score, Modified Rankin Scale (mRS) scores, and clinical and cerebrospinal fluid parameters were evaluated in patients with anti-NMDARE. Meanwhile, we performed a receiver-operator characteristic analysis to assess the power of the serum NFL in predicting the 1-year functional status.
Results
Serum NfL levels were significantly elevated in patients with anti-NMDARE compared to healthy controls (p < 0.001, padjusted < 0.001), especially in patients with severe impairments (mRS > 3 vs ≤ 3, p = 0.035) or with limited response to treatment (vs. favorable outcome, p = 0.011). Serum NFL was positively associated with the initial admission mRS (r = 0.23, p = 0.072) and 1-year mRS (r = 0.29, p = 0.018). The AUC of serum NfL and NEOS score for 1-year poor functional status was 0.697 (95% CI 0.527–0.866, p = 0.011), 0.753 (95% CI 0.616–0.890, p = 0.001), respectively. Furthermore, AUC of the combination of serum NfL and NEOS was 0.815 (95% CI 0.680–0.950, p < 0.001).
Conclusion
Our findings show that serum NfL levels evaluated in anti-NMDAR encephalitis may be a good predictor of the risk of 1-year poor functional status.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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Funding
This study was supported by the Guangdong Basic and Applied Basic Research Foundation (2021A1515010393), National Natural Science Foundation of China (NO.82071343, NO.81701188), and the First Major Talent Project of the Third Affiliated Hospital of Sun Yat-sen University (P02099).
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Conception and design of the study: Yaqing Shu, Wei Qiu. Acquisition and analysis of data: Xiaoyu Ma, Yaxin Lu, Fuhua Peng, Yuge Wang, Xiaobo Sun, Wenjing Luo, Shishi Shen, Zifeng Liu, Wei Qiu. Drafting of the text or preparing the figures: Yaqing Shu. Polishing of the text: Allan G. Kermode.
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Ma, X., Lu, Y., Peng, F. et al. Serum NfL associated with anti-NMDA receptor encephalitis. Neurol Sci 43, 3893–3899 (2022). https://doi.org/10.1007/s10072-021-05838-3
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DOI: https://doi.org/10.1007/s10072-021-05838-3