title: Cerebrospinal fluid markers of central nervous system injury in decompression illness - a case-controlled pilot study.
abstract: BACKGROUND
  Decompression sickness (DCS) may cause a wide variety of symptoms, including central nervous system (CNS) manifestations. The main objective of this study was to examine whether DCS is associated with neuronal injury, and whether DCS could result in altered amyloid metabolism.
  
  
  METHODS
  Seven, male divers with DCS and seven age-matched controls were included in the study. All the divers were treated by recompression but the controls did not receive hyperbaric oxygen. Cerebrospinal fluid (CSF) samples were collected 7-10 days after the diving injury and at three months follow-up. CSF biomarkers of neuronal injury, astroglial Injury/activation, and a range of markers of amyloid β (Aβ) metabolism, as well as two proinflammatory interleukins, were analysed using immunochemical methods.
  
  
  RESULTS
  There were no significant differences in the best-established CSF markers of neuronal injury, total tau (T-tau) and neurofilament light, between DCS patients and controls or between the two sampling time points. Also, there were no significant changes in the astroglial or amyloid (Aβ)-related markers between DCS patients and controls. However, the only diver with CNS symptoms had the highest levels of CSF T-tau, Aβ38, Aβ40 and Aβ42.
  
  
  CONCLUSIONS
  The results of our study speak against subclinical CNS injury or induction of inflammation or amyloid build-up in the brain among the six DCS patients without neurological symptoms. Further research, including on divers with CNS DCS, is justified.
authors.affiliation: Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital SE-43180 Mölndal, Sweden, Phone (mobile): +46-(0)762-704584, E-mail: pashtun.shahim@neuro.gu.se.
authors.forename: Pashtun
authors.initials: P
authors.lastname: Shahim
authors.affiliation: Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Arnell
authors.affiliation: Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kvarnström
authors.affiliation: Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Rosén
authors.affiliation: Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bremell
authors.affiliation: Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Hagberg
authors.affiliation: Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital,Mölndal, Sweden.
authors.forename: Kaj
authors.initials: K
authors.lastname: Blennow
authors.affiliation: Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital,Mölndal, Sweden, Department of Molecular Neuroscience, Reta Lila Weston Laboratories, UCL Institute of Neurology, London, UK.
authors.forename: Henrik
authors.initials: H
authors.lastname: Zetterberg
mesh_terms: D000328:Adult; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D001253:Astrocytes; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D016022:Case-Control Studies; D002490:Central Nervous System / Q000293:injuries*; D003664:Decompression; D003665:Decompression Sickness / Q000134:cerebrospinal fluid* / Q000628:therapy; D004242:Diving / Q000293:injuries*; D006801:Humans; D006931:Hyperbaric Oxygenation; D015850:Interleukin-6 / Q000134:cerebrospinal fluid; D016209:Interleukin-8 / Q000134:cerebrospinal fluid; D008297:Male; D051596:Neurocalcin / Q000134:cerebrospinal fluid; D016900:Neurofilament Proteins / Q000134:cerebrospinal fluid; D009474:Neurons; D055815:Young Adult; D016875:tau Proteins / Q000134:cerebrospinal fluid
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D051596:Neurocalcin; D016900:Neurofilament Proteins; C496688:VSNL1 protein, human; C044882:neurofilament protein L; D016875:tau Proteins
keywords: Decompression sickness; biomarkers; central nervous system; inflammation; injuries