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Sci Rep. 2016 Nov 7;6:36791. doi: 10.1038/srep36791.

Serum neurofilament light protein predicts clinical outcome in traumatic brain injury.

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Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, SE-43180 Mölndal, Sweden.
UmanDiagnostics, Umeå, Sweden.
Division of Medical Sciences, Department of Health Sciences, Luleå University of Technology, SE 971 87 Luleå, Sweden.
Clinical Memory Research Unit, Lund University, Malmö, Sweden.
Department of NVS, Karolinska Institute, Center for Alzheimer Research, Stockholm, Sweden.
Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N1PJ, UK.


Axonal white matter injury is believed to be a major determinant of adverse outcomes following traumatic brain injury (TBI). We hypothesized that measurement of neurofilament light protein (NF-L), a protein found in long white-matter axons, in blood samples, may serve as a suitable biomarker for neuronal damage in TBI patients. To test our hypotheses, we designed a study in two parts: i) we developed an immunoassay based on Single molecule array technology for quantification of NF-L in blood, and ii) in a proof-of-concept study, we tested our newly developed method on serial serum samples from severe TBI (sTBI) patients (n = 72) and controls (n = 35). We also compared the diagnostic and prognostic utility of NF-L with the established blood biomarker S100B. NF-L levels were markedly increased in sTBI patients compared with controls. NF-L at admission yielded an AUC of 0.99 to detect TBI versus controls (AUC 0.96 for S100B), and increased to 1.00 at day 12 (0.65 for S100B). Importantly, initial NF-L levels predicted poor 12-month clinical outcome. In contrast, S100B was not related to outcome. Taken together, our data suggests that measurement of serum NF-L may be useful to assess the severity of neuronal injury following sTBI.

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