Neuron-specific enolase and myelin basic protein: relationship of cerebrospinal fluid concentrations to the neurologic condition of asphyxiated full-term infants.
OBJECTIVE
We questioned whether neuron-specific enolase (NSE) and myelin basic protein (MBP) concentrations in cerebrospinal fluid (CSF) in the first 72 hours of life are correlated with the neurologic condition of asphyxiated full-term infants in the neonatal period and at 1 year of age.


METHODS
Sixty-nine asphyxiated infants were studied with serial neurologic examination, cranial ultrasonography, and neurologic follow-up. CSF samples were obtained by lumbar puncture at 12 and 72 hours of life. NSE was measured by enzyme immunoassay, and MBP was measured by radioimmunoassay.


RESULTS
Twenty infants had no neonatal encephalopathy and 49 exhibited different stages of encephalopathy. NSE and MBP concentrations in CSF at 12 and 72 hours of life were related to the degree of neonatal encephalopathy. Neither NSE nor MBP levels were correlated with any perinatal factors. Infants with documented brain injury had the highest concentrations of both NSE and MBP. The concentrations of these two biochemical markers at both 12 and 72 hours correlated with adverse outcome (death or cerebral palsy at 1 year). Based on a receiver operating characteristics curve analysis for any given specificity, NSE at 12 hours was a more accurate marker than MBP at either 12 or 72 hours for distinguishing infants with motor impairment at age 1 year from infants with normal outcome at the same age.


CONCLUSIONS
Our findings suggest that NSE and MBP are reliable biochemical markers for early estimates of hypoxic-ischemic brain damage in asphyctic full-term newborns, NSE being superior to MBP.
Garcia-Alix
A
A
Department of Pediatrics, La Paz Children's Hospital, Autonoma University of Madrid, Spain.
Cabañas
F
F
Pellicer
A
A
Hernanz
A
A
Stiris
T A
TA
Quero
J
J
D001238:Asphyxia Neonatorum / Q000134:cerebrospinal fluid* / Q000150:complications; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001925:Brain Damage, Chronic / Q000134:cerebrospinal fluid* / Q000209:etiology / Q000473:pathology; D002545:Brain Ischemia / Q000134:cerebrospinal fluid / Q000209:etiology / Q000473:pathology; D005865:Gestational Age; D006801:Humans; D002534:Hypoxia, Brain / Q000134:cerebrospinal fluid / Q000209:etiology / Q000473:pathology; D007231:Infant, Newborn; D004676:Myelin Basic Protein / Q000134:cerebrospinal fluid*; D009460:Neurologic Examination; D009485:Neuroradiography; D010264:Paraplegia / Q000209:etiology; D010751:Phosphopyruvate Hydratase / Q000134:cerebrospinal fluid*; D011446:Prospective Studies; D011782:Quadriplegia / Q000209:etiology
D015415:Biomarkers; D004676:Myelin Basic Protein; D010751:Phosphopyruvate Hydratase