An innovative approach for the evaluation of prolonged disorders of consciousness using NF-L and GFAP biomarkers: a pivotal study

Behavioral assessments during the clinical evaluation in prolonged disorders of consciousness patients could be not sufficient for a correct diagnosis and prognostication. To this aim, we used an innovative approach, involving the ultra-sensitive determination of biological markers, correlating them...

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Bibliographic Details
Published in:Scientific reports Vol. 12; no. 1; pp. 18446 - 10
Main Authors: Coppola, L., Mirabelli, P., Baldi, D., Smaldone, G., Estraneo, A., Soddu, A., Grimaldi, A. M., Mele, G., Salvatore, Marco, Cavaliere, Carlo
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 02.11.2022
Nature Publishing Group
Nature Portfolio
Subjects:
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692/53
692/617/375
Anisotropy
Biomarkers
Consciousness
Differential diagnosis
Glial Fibrillary Acidic Protein
Humanities and Social Sciences
Humans
Intermediate Filaments
multidisciplinary
Neuroimaging
Neuronal-glial interactions
Patients
Persistent Vegetative State - diagnostic imaging
Positron emission tomography
Science
Science (multidisciplinary)
Sleep and wakefulness
Substantia alba
Unconsciousness
ISSN:2045-2322, 2045-2322
Online Access:Get full text
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Summary:Behavioral assessments during the clinical evaluation in prolonged disorders of consciousness patients could be not sufficient for a correct diagnosis and prognostication. To this aim, we used an innovative approach, involving the ultra-sensitive determination of biological markers, correlating them with imaging parameters to investigate the prolonged disorders of consciousness (pDoC).We assessed the serum concentration of neurofilament light chain(NF-L) and glial fibrillary acidic protein (GFAP) in pDoC (n = 16), and healthy controls (HC, n = 6) as well as several clinical imaging parameters such as Fractional Anisotropy (FA), Whole Brain SUV, and White Matter Hyperintensities volumes (WMH) using PET-MRI acquisition. As for differential diagnosis task, only the imaging WMH volume was able to discriminate between vegetative state/unresponsive wakefulness syndrome (VS/UWS), and minimally conscious state (MCS) patients ( p -value < 0.01), while all selected markers (both imaging and in vitro) were able to differentiate between pDoC patients and HC. At subject level, serum NF-L concentrations significantly differ according to clinical progression and consciousness recovery ( p -value < 0.01), highlighting a potential play for the longitudinal management of these patients.
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-022-21930-w