title: Cerebrospinal fluid markers of neuronal and glial cell damage in patients with autoimmune neurologic syndromes with and without underlying malignancies.
abstract: Autoimmune neurologic syndromes can be paraneoplastic (associated with malignancies and/or onconeural antibodies), or non-paraneoplastic. Their clinical presentation is often similar. As prognosis is related to malignancy treatment, better biomarkers are needed to identify patients with malignancy. We investigated cerebrospinal fluid (CSF) markers of neuronal (neurofilament light chain, NFL and total tau protein, T-tau) and glial (glial fibrillary acidic protein) damage. CSF-NFL and T-tau were increased in both paraneoplastic and non-paraneoplastic autoimmune syndromes. Patients with manifest malignancies were older, had less epilepsy, more focal central and peripheral neurological signs and symptoms, and worse long-term outcome, than those without malignancy. CSF-NFL-levels predicted long-term outcome but were not diagnostic for malignancy, after age adjustment.
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden. Electronic address: radu.constantinescu@vgregion.se.
authors.forename: Radu
authors.initials: R
authors.lastname: Constantinescu
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
authors.forename: David
authors.initials: D
authors.lastname: Krýsl
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Andrén
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Neurology Department, Waikato Clinical Campus, Auckland University, New Zealand.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Asztély
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
authors.forename: Filip
authors.initials: F
authors.lastname: Bergquist
authors.affiliation: Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom.
authors.forename: Henrik
authors.initials: H
authors.lastname: Zetterberg
authors.affiliation: Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Andreasson
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Axelsson
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
authors.forename: Elinor Ben
authors.initials: EB
authors.lastname: Menachem
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Jons
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
authors.forename: Ubah
authors.initials: U
authors.lastname: Mahamud
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Laboratory for Clinical immunology, Sahlgrenska University Hospital, Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
authors.forename: Clas
authors.initials: C
authors.lastname: Malmeström
authors.affiliation: Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Neurology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rosengren
authors.affiliation: Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
authors.forename: Kaj
authors.initials: K
authors.lastname: Blennow
mesh_terms: D020274:Autoimmune Diseases of the Nervous System / Q000134:cerebrospinal fluid* / Q000150:complications* / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009369:Neoplasms / Q000134:cerebrospinal fluid* / Q000150:complications* / Q000000981:diagnostic imaging; D009419:Nerve Tissue Proteins / Q000134:cerebrospinal fluid*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: D015415:Biomarkers; D009419:Nerve Tissue Proteins; D016875:tau Proteins
keywords: Autoimmune encephalitis; Autoimmune neurological syndrome; Neurofilament light chain; Non-paraneoplastic; Paraneoplastic neurologic syndrome; Tau protein