title: Cerebrospinal fluid tau proteins in status epilepticus.
abstract: Tau protein is a phosphorylated microtubule-associated protein, principally localized at neuronal level in the central nervous system (CNS). Tau levels in the cerebrospinal fluid (CSF) are considered to index both axonal and neuronal damage. To date, however, no study has specifically evaluated the CSF levels of tau proteins in patients with status epilepticus (SE). We evaluated these established biomarkers of neuronal damage in patients with SE who received a lumbar puncture during SE between 2007 and 2014. Status epilepticus cases due to acute structural brain damage, including CNS infection, were excluded. Clinical, biological, therapeutic, and follow-up data were collected. Group comparison between patients stratified according to SE response to antiepileptic drugs (AEDs), disability, and epilepsy outcomes were performed. Twenty-eight patients were considered for the analyses (mean age 56 years): 14 patients had abnormally high CSF t-tau level, six patients had abnormally high CSF p-tau level, and only three patients had abnormally low Aβ1-42 level. Cerebrospinal fluid t-tau value was higher in patients who developed a refractory SE compared to patients with seizures controlled by AED. Cerebrospinal fluid t-tau values were positively correlated with SE duration and were higher in patients treated with propofol anesthesia compared to patients that had not received this treatment. Patients with higher CSF t-tau had higher risk of developing disability (OR = 32.5, p = 0.004) and chronic epilepsy (OR = 12; p = 0.016) in comparison with patients with lower CSF t-tau level. Our results suggest that CSF t-tau level might be proposed as a biomarker of SE severity and prognosis. Prospective studies are needed to evaluate the effects of propofol on tau pathology in this setting. This article is part of a Special Issue entitled "Status Epilepticus".
authors.affiliation: Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, NOCSAE Hospital, AUSL Modena, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Monti
authors.affiliation: Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, NOCSAE Hospital, AUSL Modena, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Tondelli
authors.affiliation: Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, NOCSAE Hospital, AUSL Modena, Italy.
authors.forename: Giada
authors.initials: G
authors.lastname: Giovannini
authors.affiliation: Neurology Unit, NOCSAE Hospital, AUSL Modena, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Bedin
authors.affiliation: Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, NOCSAE Hospital, AUSL Modena, Italy.
authors.forename: Paolo F
authors.initials: PF
authors.lastname: Nichelli
authors.affiliation: Clinical Pathology-Toxicology, NOCSAE Hospital, ASL Modena, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Trenti
authors.affiliation: Department of Biomedical, Metabolic, and Neural Science, University of Modena and Reggio Emilia, Modena, Italy; Neurology Unit, NOCSAE Hospital, AUSL Modena, Italy. Electronic address: stefano.meletti@unimore.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Meletti
authors.affiliation: Neurology Unit, NOCSAE Hospital, AUSL Modena, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Chiari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid / Q000378:metabolism; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002556:Cerebrospinal Fluid Proteins / Q000134:cerebrospinal fluid / Q000378:metabolism; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000134:cerebrospinal fluid / Q000378:metabolism; D011446:Prospective Studies; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D055815:Young Adult; D016875:tau Proteins / Q000134:cerebrospinal fluid* / Q000378:metabolism
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers; D002556:Cerebrospinal Fluid Proteins; D010446:Peptide Fragments; D016875:tau Proteins
keywords: Biomarkers; Epilepsy; Refractory status epilepticus; Seizures; Status epilepticus; Tau