title: Total-tau and neurofilament light in CSF reflect spinal cord ischaemia after endovascular aortic repair.
abstract: BACKGROUND
  Repair of extensive aortic disease may be associated with spinal cord ischaemia (SCI). Here we test if levels of cerebrospinal fluid (CSF) biomarkers for neuronal injury are altered in patients with SCI after advanced endovascular repair in extensive aortic disease.
  
  
  METHODS
  CSF was sampled for up to 48 h in ten patients undergoing endovascular aortic repair and analyzed for the axonal damage markers total-tau (T-tau) and neurofilament light (NFL).
  
  
  RESULTS
  Six of ten patients developed SCI (clinically present within 3-6 h). CSF levels of NFL increased up to 37-fold in patients with, but were stable in patients without, SCI. CSF levels of T-tau also increased in patients with SCI, but with some overlap with patients without SCI. Levels of NFL and T-tau did not increase until after the appearance of clinical signs of neurological dysfunction (12-48 h after aortic repair).
  
  
  CONCLUSIONS
  The CSF biomarkers NFL and T-tau both reflect development of SCI after endovascular aortic repair, but do not rise until after clinical signs of SCI appear. Future studies are desirable to further evaluate potential use of these biomarkers for assessment of the severity of SCI, and also to identify earlier biomarkers of SCI.
authors.affiliation: Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund University, Skåne University Hospital, Malmö, Sweden. Electronic address: edyta.merisson@skane.se.
authors.forename: Edyta
authors.initials: E
authors.lastname: Merisson
authors.affiliation: Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Skåne University Hospital, SE-20502 Malmö, Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Mattsson
authors.affiliation: Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Skåne University Hospital, SE-20502 Malmö, Sweden; UCL Institute of Neurology, London, UK.
authors.forename: Henrik
authors.initials: H
authors.lastname: Zetterberg
authors.affiliation: Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Skåne University Hospital, SE-20502 Malmö, Sweden.
authors.forename: Kaj
authors.initials: K
authors.lastname: Blennow
authors.affiliation: Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund University, Skåne University Hospital, Malmö, Sweden; Center for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Pikwer
authors.affiliation: Department of Clinical Sciences Malmö, Vascular Center, Skåne University Hospital, Malmö, Sweden.
authors.forename: Irma
authors.initials: I
authors.lastname: Mehmedagic
authors.affiliation: Department of Clinical Sciences Malmö, Vascular Center, Skåne University Hospital, Malmö, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Acosta
authors.affiliation: Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund University, Skåne University Hospital, Malmö, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Åkeson
mesh_terms: D001011:Aorta / Q000601:surgery*; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016900:Neurofilament Proteins / Q000134:cerebrospinal fluid*; D011446:Prospective Studies; D020760:Spinal Cord Ischemia / Q000134:cerebrospinal fluid* / Q000601:surgery; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: D015415:Biomarkers; D016900:Neurofilament Proteins; D016875:tau Proteins
keywords: Aortic disease; Biomarker; Cerebrospinal fluid; Endovascular; NFL; Tau