Raised Plasma Neurofilament Light Protein Levels After Rewarming Are Associated With Adverse Neurodevelopmental Outcomes in Newborns After Therapeutic Hypothermia

Frontiers in Neurology
Divyen K ShahPhilippa Chisholm

Abstract

Aim: To determine the predictive value of plasma neurofilament light protein (NfL) as a prognostic marker for outcomes in babies who have undergone therapeutic hypothermia (TH) for hypoxic ischemic encephalopathy (HIE). Method: NfL levels from three groups of term newborns were compared: (1) those with mild HIE who did not receive TH, (2) newborns treated with TH who had minimal or no brain injury on MRI, and (3) newborns treated with TH who had substantial brain injury on MRI. Follow-up outcomes were collected from 18 months onward. Results: Follow-up was available for 33/37 (89%) of children. A cutoff NfL level >436 pg/ml after rewarming (median age 98 h) was associated with adverse outcome with a diagnostic sensitivity 75%, specificity 77%, PPV 75%, and NPV 77%. NfL levels at earlier time points were not predictive of outcome. Interpretation: This pilot study shows that persistently raised plasma NfL levels after rewarming are associated with adverse outcomes in babies with HIE who have undergone TH.

References

Feb 1, 2011·Annals of Neurology·Martin GunnarssonJan Lycke
Feb 27, 2013·The Cochrane Database of Systematic Reviews·Susan E JacobsPeter G Davis
Mar 28, 2017·JAMA Neurology·Niklas MattssonUNKNOWN Alzheimer’s Disease Neuroimaging Initiative
Jun 21, 2017·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Hanna ToorellHenrik Hagberg
Jan 19, 2018·Current Opinion in Pediatrics·Ernest M GrahamFrances J Northington
Apr 11, 2019·Journal of Neurology, Neurosurgery, and Psychiatry·Lorenzo GaetaniHenrik Zetterberg
Sep 30, 2019·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Pavithira TharmapoopathyDivyen K Shah

❮ Previous
Next ❯

Software Mentioned

GraphPad Prism
SPSS

Related Concepts

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.