Open AccessDetection of Phosphorylated NF-H in the Cerebrospinal Fluid and Blood of Aneurysmal Subarachnoid Hemorrhage Patients
Author(s) -
Stephen B. Lewis,
Regina A. Wolper,
Lynn Miralia,
Cui Yang,
Gerry Shaw
Publication year - 2008
Publication title -
journal of cerebral blood flow and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.167
H-Index - 193
eISSN - 1559-7016
pISSN - 0271-678X
DOI - 10.1038/jcbfm.2008.12
Subject(s) - subarachnoid hemorrhage , cerebrospinal fluid , medicine , vasospasm , biomarker , neurofilament , anesthesia , cerebral vasospasm , aneurysm , pathology , gastroenterology , cardiology , surgery , immunohistochemistry , biology , biochemistry
Blood and cerebrospinal fluid (CSF) of 30 Fisher grade 3 aneurysmal subarachnoid hemorrhage (ASAH) patients were analyzed for the presence of the phosphorylated axonal form of the major neurofilament subunit NF-H (pNF-H), a promising biomarker of axonal injury. Patient demographic data including development of vasospasm and outcome scores at 6 months after aneurysmal rupture (AR) were evaluated. Higher pNF-H blood levels in the first few days after AR were strongly predictive of a negative outcome. Blood pNF-H levels in most recovering patients showed a steady increase into the second week after AR, presumably reflecting axonal degeneration secondary to the original insult. Almost half of the patients studied showed sudden dramatic peaks of pNF-H protein release into CSF in the 3- to 14-day time period after AR, which must reflect profound, coordinated, and secondary loss of axons. Patients in whom vasospasm was detected had significantly more pNF-H in both blood and CSF compared with those in whom vasospasm was not detected. We conclude that the analysis of pNF-H levels in blood and CSF differentiates between patients with poor and favorable outcomes and also reveals several novel features of ASAH progression and recovery.