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Cerebrospinal fluid biomarkers in patients with neurological symptoms but without neurological diseases
Author(s) -
Constantinescu Radu,
Mahamud Ubah,
Constantinescu Clara,
Eriksson Barbro,
Novakova Lenka,
Olsson Bob,
Rosengren Lars,
Blennow Kaj,
Axelsson Markus
Publication year - 2019
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13118
Subject(s) - cerebrospinal fluid , medicine , pathology
Background Elevated levels of the cerebrospinal fluid (CSF) neuronal injury markers (neurofilament light chain [NF‐L] and total tau protein [t‐tau]) and of the astroglial marker glial fibrillary acidic protein (GFAP) are found in etiologically different neurological disorders affecting the peripheral and the central nervous system. Aims To explore the role of CSF biomarkers in the clinical management of patients admitted for alarming neurological symptoms, but in whom neurological disorders could be excluded. Methods Study participants were patients seeking medical attention for neurological symptoms primarily considered to be caused by a neurological diagnosis and investigated according to clinical routine. Demographic, clinical, and CSF data were extracted retrospectively from medical records. Patients with a final neurological diagnosis were excluded. Results Out of 990 patients, 900 with a neurological diagnosis were excluded leaving 90 patients without a final neurological diagnosis. Sixty‐eight (75.6%) were females. Median (range) age at lumbar puncture was 34.7 (16.9‐65.1) years. Age‐adjusted CSF‐NF‐L, CSF‐t‐tau, and CSF‐GFAP concentrations were normal in 89 (98.9%), 86 (95.6%), and 87 (96.7%) patients, respectively. Conclusion In patients with significant neurological symptoms but in whom a neurological diagnosis could not be made, the CSF markers NF‐L, t‐tau, and GFAP did not indicate signs of neuronal or astroglial cell damage close to symptom onset. Consequently, increased levels of CSF markers are not expected in this patient group and, if present, should raise suspicion of underlying neurological disorders and motivate further investigations.