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Prognosticating acute traumatic spinal cord injury using Neurofilament (NF), Neuron Specific Enolase (NSE), Matrix Metalloproteinases (MMPs), and S-100B as biomarkers

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Abstract

Background

Spinal cord injury (SCI) can result in lifelong disability. Currently, the literature suggests that biomarkers are helpful in prognosticating SCI, but there is no specific biomarker to date. This is the first study that predicted the prognosis dynamically using biomarkers.

Aim

To elucidate the role of biomarkers in prognosticating acute traumatic SCI.

Methods

Blood samples were obtained from 35 patients of acute traumatic SCI at presentation, immediate post-op, and at 6 weeks. At 6 months follow-up, patients were divided into two groups, i.e, improved and non-improved based on the improvement in the ASIA grade compared to presentation. A non-parametric test was used for comparing mean NSE, MMP-2, S100-B, and NF serum levels at presentation, immediate post-op, and 6 weeks post-op follow-up between the two groups.

Results

There was a significant difference (p = 0.03) in the NF values at presentation between the two groups. The difference of NSE values at 6 weeks was also significant (p = 0.016) between the two groups. S-100B levels were also significantly different between both groups at presentation (p=0.016), and at the immediate post-op stage (p=0.007). MMP-2 levels neither displayed any specific trend nor any significant difference between the two groups.

Conclusion

Higher NF values at presentation, and higher S-100B levels at presentation and immediate post-operative period correlated with poor outcome. Also, increased NSE values after surgery are indicative of no improvement. These levels can be used at various stages to predict the prognosis. However, further studies are required on this topic extensively to know the exact cut-off values of these markers to predict the prognosis accurately.

Clinical trials registry number

REF/2020/01/030616

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Acknowledgements

This research study was funded by AO Trauma Asia Pacific with a research grant of 3000 CHF and by an intramural research grant of 5 lacs from PGIMER, Chandigarh, India.

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Authors and Affiliations

  1. Department of Orthopaedics, ESIC Medical College and Hospital, Kalaburagi, Karnataka, India

    Sachin Paragond

  2. Department of Orthopaedics, PGIMER, Chandigarh, India

    Sarvdeep Singh Dhatt, Vishal Kumar, Ankit Gaurav & Deepak Neradi

  3. Department of Biochemistry, PGIMER, Chandigarh, India

    Deepy Zohmangaihi & Arnab Pal

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  1. Sachin Paragond
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  2. Sarvdeep Singh Dhatt
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  3. Vishal Kumar
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Correspondence to Vishal Kumar.

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Ethical approval

This study was approved by the Institutional Ethics Committee of PGIMER, Chandigarh vide letter no. INT/IEC/2019/002793 in their meeting held on 12/09/2018. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study and in case it was not possible to take direct consent from the participant, informed consent was obtained from the legal guardians.

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Paragond, S., Dhatt, S.S., Kumar, V. et al. Prognosticating acute traumatic spinal cord injury using Neurofilament (NF), Neuron Specific Enolase (NSE), Matrix Metalloproteinases (MMPs), and S-100B as biomarkers. Ir J Med Sci 193, 769–775 (2024). https://doi.org/10.1007/s11845-023-03476-6

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  • DOI: https://doi.org/10.1007/s11845-023-03476-6

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