j - JOUR T1 -血清神经丝轻链水平对抗nmda受体脑炎的预测价值[j] - Neurology . JO - Neurology . 10.1212/WNL.0000000000207221首页Sp - 10.1212/ wnl.0000000000207221非盟-朱丽叶·布伦纳盟莎拉Mariotto AU -安娜E.M. Bastiaansen盟曼Paunovic AU -塞尔吉奥·法拉利盟Daniela阿尔贝蒂盟Marienke A.A.M. de Bruijn AU -伊薇特美国Crijnen盟马可•j•Schreurs AU - Rinze弗雷德里克Neuteboom AU - Jan G.M.C. Damoiseaux AU - Juna m . de Vries盟Maarten j . Titulaer Y1 - 2023/04/04 UR - //www.ez-admanager.com/content/early/2023/04/03/WNL.0000000000207221.abstract N2 -背景和目标疾病活首页动的决定因素和预后局限于抗nmdar脑炎。神经丝轻链(NfL)是轴突损伤的标志物，已被确定为神经退行性疾病和其他神经炎症疾病的有价值的生物标志物。我们的目的是研究抗nmdar脑炎患者血清NfL水平作为疾病严重程度和预后的生物标志物。方法在这项回顾性研究中，测量了全国抗nmdar脑炎队列中所有可用的治疗前血清和配对脑脊液样本的NfL值。使用单分子阵列(SIMOA)对这些值进行重复分析，并与健康参考文献的测量结果进行比较。如果诊断后至少有两个时间点，则对随访血清进行检测以分析纵向反应性。使用回归分析将血清NfL水平与疾病活动性(癫痫发作、MRI和CSF结果)、严重程度(mRS、入院天数、ICU入院)和结局(mRS和复发)数据进行比较。结果纳入71例患者(75%为女性; mean age 31.4, range 0-85 years). Paired CSF samples were available of 33 patients, follow-up samples of 20 patients. Serum NfL levels at diagnosis were higher in patients (mean 19.5 pg/mL, 95%-CI 13.7-27.7) than in references (mean 6.4 pg/mL, 95%-CI 5.8-7.2, p<0.0001). We observed a good correlation between serum and CSF NfL values (R=0.84, p<0.0001). Serum NfL levels and age correlated in patients (Pearson’s R=0.57, p<0.0001) and references (R=0.62, p<0.0001). Increased NfL values were detected in patients post-HSV1 encephalitis (mean 248.8 vs 14.1 pg/mL, p <0.0001) and in patients with brain MRI lesions (mean 27.3 vs 11.1 pg/mL, p=0.019). NfL levels did relate to the long-term follow-up (mRS at 12 months; βNfL=0.55, p=0.013), although largely explained by the effect of age on NfL levels and prognosis. In serial samples, NfL values did roughly follow clinical disease activity, albeit with delay.Discussion/Conclusions Increased serum NfL levels reflect neuro-axonal damage in anti-NMDAR encephalitis. No relationship was identified with disease severity, while the association with outcome was confounded by age. The implied role of sampling timing on NfL levels also limits the applicability of NfL as a prognostic marker. ER -