Serial cerebrospinal fluid neurofilament heavy chain levels in severe Guillain-Barré syndrome

Authors

  • Irena Dujmovic MD, PhD,

    1. University of Belgrade Faculty of Medicine Department of Neurology & Clinic of Neurology, Clinical Centre of Serbia, Belgrade, Serbia
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  • Michael P. Lunn PhD, FRCP,

    1. MRC Centre for Neuromuscular Diseases & Neuroimmunology and CSF Laboratory, National Hospital for Neurology, London, United Kingdom
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  • Mary M. Reilly MD, FRCP,

    1. MRC Centre for Neuromuscular Diseases, Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
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  • Axel Petzold MD, PhD

    Corresponding author
    • UCL Institute of Neurology, Department of Neuroinflammation, London, UK & VUmc, Department of Neurology, HV, Amsterdam, The Netherlands
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Correspondence to: A. Petzold; e-mail: a.petzold@vumc.nl

ABSTRACT

Introduction

Proximal axonotmesis results in the release of neurofilament (Nf) proteins into the cerebrospinal fluid (CSF) in patients with Guillain-Barré syndrome (GBS). High CSF levels of the phosphorylated form of Nf-heavy chain (NfHSMI35) at GBS onset have been reported to be a poor prognostic marker, but routine measurement of CSF NfHSMI35 levels has not been done and the longitudinal profile of CSF NfHSMI35 levels in GBS is not known.

Methods

This prospective case series describes the clinical, neurophysiological, and biomarker characteristics of 3 patients with severe GBS.

Results

High and increasing levels of CSF NfHSMI35 in serial CSF samples were associated with poor clinical and electrophysiological outcome.

Conclusions

These data further suggest that CSF NfHSMI35 could be a prognostic biomarker which might indicate the development of retrograde axonal degeneration or additional proximal axonal damage during the course of GBS. Muscle Nerve, 2013

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