Structural biomarkers in the cerebrospinal fluid within 24 h after a traumatic spinal cord injury: a descriptive analysis of 16 subjects.
METHODS
Prospective cohort study.


OBJECTIVE
To characterize the cerebrospinal fluid (CSF) concentrations of glial fibrillary acidic protein, neuron specific enolase (NSE), S-100β, tau and neurofilament heavy chain (NFH) within 24 h of an acute traumatic spinal cord injury (SCI), and to correlate these concentrations with the baseline severity of neurologic impairment as graded by the American Spinal Injury Association impairment scale (AIS).


METHODS
A lumbar puncture was performed to obtain CSF from 16 acute traumatic SCI patients within 24 h post injury. Neurological examinations were performed within 24 h of injury and again at 6 or 12 months post injury. The correlations between the CSF concentrations and initial AIS were calculated by using Pearson correlation coefficients. In addition, an independent Student's t-test was used to test for differences in CSF concentrations between patients of different AIS grades.


RESULTS
The CSF NSE concentrations were significantly correlated with the baseline neurologic impairment being either 'motor complete' (AIS A, B) or 'motor incomplete' (AIS C, D) (r=0.520, P<0.05). The mean S-100β concentration in motor complete patients was significantly higher compared with motor incomplete patients; 377.2 μg l(-1) (s.d.±523 μg l(-1)) vs 57.1 μg l(-1) (s.d.±56 μg l(-1)) (P<0.05), respectively. Lastly, the mean NFH concentration in motor complete patients was significantly higher compared with motor incomplete patient, 11 813 ng l(-1) (s.d.±16 195 ng l(-1)) vs 1446.8 ng l(-1) (s.d.±1533 ng l(-1)), (P<0.05), respectively.


CONCLUSIONS
In this study we identified differences in the structural CSF biomarkers NSE, S-100β and NFH between motor complete and motor incomplete SCI patients. Our data showed no clear differences in any of the protein concentrations between the different AIS grades.
Department of Orthopedic Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
M H
MH
Pouw
Combined Neurosurgical and Orthopaedic Spine Program (CNOSP), Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.
B K
BK
Kwon
1] Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands [2] Department of Laboratory Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
M M
MM
Verbeek
Department of Neurology, Slingeland Hospital, Doetinchem, The Netherlands.
P E
PE
Vos
Department of Orthopedic Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
A
A
van Kampen
Combined Neurosurgical and Orthopaedic Spine Program (CNOSP), Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.
C G
CG
Fisher
Combined Neurosurgical and Orthopaedic Spine Program (CNOSP), Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.
J
J
Street
Combined Neurosurgical and Orthopaedic Spine Program (CNOSP), Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.
S J
SJ
Paquette
Combined Neurosurgical and Orthopaedic Spine Program (CNOSP), Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.
M F
MF
Dvorak
Combined Neurosurgical and Orthopaedic Spine Program (CNOSP), Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.
M C
MC
Boyd
Department of Orthopedic Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
A J F
AJ
Hosman
Department of Rehabilitation Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
H
H
van de Meent
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000134:cerebrospinal fluid; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000134:cerebrospinal fluid; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010751:Phosphopyruvate Hydratase / Q000134:cerebrospinal fluid; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D064568:S100 Calcium Binding Protein beta Subunit / Q000134:cerebrospinal fluid; D013119:Spinal Cord Injuries / Q000134:cerebrospinal fluid*; D013129:Spinal Puncture; D013997:Time Factors; D055815:Young Adult; D016875:tau Proteins / Q000134:cerebrospinal fluid
D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; C054369:MAPT protein, human; D064568:S100 Calcium Binding Protein beta Subunit; D016875:tau Proteins; D010751:Phosphopyruvate Hydratase