Early levels of GFAP and NF-L in predicting the outcome of mild TBI

Iftakher Hossain (Corresponding Author), Mehrbod Mohammadian, Riikka SK Takala, Olli Tenovuo, Linnéa Lagerstedt, Henna Maria Ala-Seppälä, Janek Frantzén, Mark Van Gils, Peter John Hutchinson, Ari J Katila, Henna-Riikka Maanpää, David Menon, Virginia Newcombe, Jussi Tallus, Kevin Hrusovsky, David Wilson, Kaj Blennow, Jean-Charles Sanchez, Henrik Zetterberg, Jussi P Posti

Research output: Contribution to journalArticleResearchpeer-review

Abstract

To correlate the early levels of glial fibrillary acidic protein (GFAP) and neurofilament light protein (NF-L) with outcome in patients with mild traumatic brain injury (mTBI). 107 patients with mTBI [Glasgow Coma Scale (GCS) ≥13] having the blood samples for GFAP and NF-L available within 24 hrs from arrival were included. Patients with mTBI were divided into computed tomography (CT)-positive and CT-negative groups. Glasgow Outcome Scale extended (GOSE) was used to assess the outcome. Outcomes were defined as complete (GOSE 8) vs. incomplete (GOSE <8), and favorable (GOSE 5-8) vs. unfavorable (GOSE 1-4). GFAP and NF-L concentrations in blood were measured using ultrasensitive single molecule array technology. Patients with incomplete recovery had significantly higher levels of NF-L compared to those with complete recovery (p=0.005). The levels of GFAP and NF-L were significantly higher in patients with unfavorable outcome than in patients with favorable outcome (p=0.002 for GFAP and p <0.001 for NF-L). For predicting favorable outcome, the area under the ROC curve for GFAP and NF-L was 0.755 and 0.826, respectively. In a multivariate logistic regression model, the level of NF-L was still a significant predictor for complete recovery (OR=1.008, 95%CI, 1.000-1.016). Moreover, the level of NF-L was a significant predictor for complete recovery in CT-positive patients (OR=1.009, 95%CI, 1.001-1.016). The early levels of GFAP and NF-L are significantly correlated with the outcome in patients with mTBI. The level of NF-L within 24 hrs from arrival has a significant predictive value in mTBI also in a multivariate model.
LanguageEnglish
JournalJournal of Neurotrauma
Early online date8 Jan 2019
DOIs
Publication statusE-pub ahead of print - 8 Jan 2019
MoE publication typeNot Eligible

Fingerprint

Glial Fibrillary Acidic Protein
Brain Concussion
Glasgow Outcome Scale
Tomography
neurofilament protein L
Logistic Models
Glasgow Coma Scale
ROC Curve
Area Under Curve
Technology

Keywords

  • biomarkes
  • traumatic brain injury
  • outcome measures

Cite this

Hossain, I., Mohammadian, M., Takala, R. SK., Tenovuo, O., Lagerstedt, L., Ala-Seppälä, H. M., ... Posti, J. P. (2019). Early levels of GFAP and NF-L in predicting the outcome of mild TBI. Journal of Neurotrauma. https://doi.org/10.1089/NEU.2018.5952
Hossain, Iftakher ; Mohammadian, Mehrbod ; Takala, Riikka SK ; Tenovuo, Olli ; Lagerstedt, Linnéa ; Ala-Seppälä, Henna Maria ; Frantzén, Janek ; Van Gils, Mark ; Hutchinson, Peter John ; Katila, Ari J ; Maanpää, Henna-Riikka ; Menon, David ; Newcombe, Virginia ; Tallus, Jussi ; Hrusovsky, Kevin ; Wilson, David ; Blennow, Kaj ; Sanchez, Jean-Charles ; Zetterberg, Henrik ; Posti, Jussi P. / Early levels of GFAP and NF-L in predicting the outcome of mild TBI. In: Journal of Neurotrauma. 2019.
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abstract = "To correlate the early levels of glial fibrillary acidic protein (GFAP) and neurofilament light protein (NF-L) with outcome in patients with mild traumatic brain injury (mTBI). 107 patients with mTBI [Glasgow Coma Scale (GCS) ≥13] having the blood samples for GFAP and NF-L available within 24 hrs from arrival were included. Patients with mTBI were divided into computed tomography (CT)-positive and CT-negative groups. Glasgow Outcome Scale extended (GOSE) was used to assess the outcome. Outcomes were defined as complete (GOSE 8) vs. incomplete (GOSE <8), and favorable (GOSE 5-8) vs. unfavorable (GOSE 1-4). GFAP and NF-L concentrations in blood were measured using ultrasensitive single molecule array technology. Patients with incomplete recovery had significantly higher levels of NF-L compared to those with complete recovery (p=0.005). The levels of GFAP and NF-L were significantly higher in patients with unfavorable outcome than in patients with favorable outcome (p=0.002 for GFAP and p <0.001 for NF-L). For predicting favorable outcome, the area under the ROC curve for GFAP and NF-L was 0.755 and 0.826, respectively. In a multivariate logistic regression model, the level of NF-L was still a significant predictor for complete recovery (OR=1.008, 95{\%}CI, 1.000-1.016). Moreover, the level of NF-L was a significant predictor for complete recovery in CT-positive patients (OR=1.009, 95{\%}CI, 1.001-1.016). The early levels of GFAP and NF-L are significantly correlated with the outcome in patients with mTBI. The level of NF-L within 24 hrs from arrival has a significant predictive value in mTBI also in a multivariate model.",
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Hossain, I, Mohammadian, M, Takala, RSK, Tenovuo, O, Lagerstedt, L, Ala-Seppälä, HM, Frantzén, J, Van Gils, M, Hutchinson, PJ, Katila, AJ, Maanpää, H-R, Menon, D, Newcombe, V, Tallus, J, Hrusovsky, K, Wilson, D, Blennow, K, Sanchez, J-C, Zetterberg, H & Posti, JP 2019, 'Early levels of GFAP and NF-L in predicting the outcome of mild TBI', Journal of Neurotrauma. https://doi.org/10.1089/NEU.2018.5952

Early levels of GFAP and NF-L in predicting the outcome of mild TBI. / Hossain, Iftakher (Corresponding Author); Mohammadian, Mehrbod; Takala, Riikka SK; Tenovuo, Olli; Lagerstedt, Linnéa; Ala-Seppälä, Henna Maria; Frantzén, Janek; Van Gils, Mark; Hutchinson, Peter John; Katila, Ari J; Maanpää, Henna-Riikka; Menon, David; Newcombe, Virginia; Tallus, Jussi; Hrusovsky, Kevin; Wilson, David; Blennow, Kaj; Sanchez, Jean-Charles; Zetterberg, Henrik; Posti, Jussi P.

In: Journal of Neurotrauma, 08.01.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Early levels of GFAP and NF-L in predicting the outcome of mild TBI

AU - Hossain, Iftakher

AU - Mohammadian, Mehrbod

AU - Takala, Riikka SK

AU - Tenovuo, Olli

AU - Lagerstedt, Linnéa

AU - Ala-Seppälä, Henna Maria

AU - Frantzén, Janek

AU - Van Gils, Mark

AU - Hutchinson, Peter John

AU - Katila, Ari J

AU - Maanpää, Henna-Riikka

AU - Menon, David

AU - Newcombe, Virginia

AU - Tallus, Jussi

AU - Hrusovsky, Kevin

AU - Wilson, David

AU - Blennow, Kaj

AU - Sanchez, Jean-Charles

AU - Zetterberg, Henrik

AU - Posti, Jussi P

PY - 2019/1/8

Y1 - 2019/1/8

N2 - To correlate the early levels of glial fibrillary acidic protein (GFAP) and neurofilament light protein (NF-L) with outcome in patients with mild traumatic brain injury (mTBI). 107 patients with mTBI [Glasgow Coma Scale (GCS) ≥13] having the blood samples for GFAP and NF-L available within 24 hrs from arrival were included. Patients with mTBI were divided into computed tomography (CT)-positive and CT-negative groups. Glasgow Outcome Scale extended (GOSE) was used to assess the outcome. Outcomes were defined as complete (GOSE 8) vs. incomplete (GOSE <8), and favorable (GOSE 5-8) vs. unfavorable (GOSE 1-4). GFAP and NF-L concentrations in blood were measured using ultrasensitive single molecule array technology. Patients with incomplete recovery had significantly higher levels of NF-L compared to those with complete recovery (p=0.005). The levels of GFAP and NF-L were significantly higher in patients with unfavorable outcome than in patients with favorable outcome (p=0.002 for GFAP and p <0.001 for NF-L). For predicting favorable outcome, the area under the ROC curve for GFAP and NF-L was 0.755 and 0.826, respectively. In a multivariate logistic regression model, the level of NF-L was still a significant predictor for complete recovery (OR=1.008, 95%CI, 1.000-1.016). Moreover, the level of NF-L was a significant predictor for complete recovery in CT-positive patients (OR=1.009, 95%CI, 1.001-1.016). The early levels of GFAP and NF-L are significantly correlated with the outcome in patients with mTBI. The level of NF-L within 24 hrs from arrival has a significant predictive value in mTBI also in a multivariate model.

AB - To correlate the early levels of glial fibrillary acidic protein (GFAP) and neurofilament light protein (NF-L) with outcome in patients with mild traumatic brain injury (mTBI). 107 patients with mTBI [Glasgow Coma Scale (GCS) ≥13] having the blood samples for GFAP and NF-L available within 24 hrs from arrival were included. Patients with mTBI were divided into computed tomography (CT)-positive and CT-negative groups. Glasgow Outcome Scale extended (GOSE) was used to assess the outcome. Outcomes were defined as complete (GOSE 8) vs. incomplete (GOSE <8), and favorable (GOSE 5-8) vs. unfavorable (GOSE 1-4). GFAP and NF-L concentrations in blood were measured using ultrasensitive single molecule array technology. Patients with incomplete recovery had significantly higher levels of NF-L compared to those with complete recovery (p=0.005). The levels of GFAP and NF-L were significantly higher in patients with unfavorable outcome than in patients with favorable outcome (p=0.002 for GFAP and p <0.001 for NF-L). For predicting favorable outcome, the area under the ROC curve for GFAP and NF-L was 0.755 and 0.826, respectively. In a multivariate logistic regression model, the level of NF-L was still a significant predictor for complete recovery (OR=1.008, 95%CI, 1.000-1.016). Moreover, the level of NF-L was a significant predictor for complete recovery in CT-positive patients (OR=1.009, 95%CI, 1.001-1.016). The early levels of GFAP and NF-L are significantly correlated with the outcome in patients with mTBI. The level of NF-L within 24 hrs from arrival has a significant predictive value in mTBI also in a multivariate model.

KW - biomarkes

KW - traumatic brain injury

KW - outcome measures

U2 - 10.1089/NEU.2018.5952

DO - 10.1089/NEU.2018.5952

M3 - Article

JO - Journal of Neurotrauma

T2 - Journal of Neurotrauma

JF - Journal of Neurotrauma

SN - 0897-7151

ER -

Hossain I, Mohammadian M, Takala RSK, Tenovuo O, Lagerstedt L, Ala-Seppälä HM et al. Early levels of GFAP and NF-L in predicting the outcome of mild TBI. Journal of Neurotrauma. 2019 Jan 8. https://doi.org/10.1089/NEU.2018.5952