AUTHOR=Jin Mei , Liu Kang , Zhao Libo , Liu Jing , Zhao Ziwei , Zhao Yifan , Sun Suzhen 

TITLE=Cerebrospinal fluid neurofilament light chain predicts short-term prognosis in pediatric Guillain-Barré syndrome

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.972367

DOI=10.3389/fneur.2022.972367

ISSN=1664-2295

ABSTRACT=<sec><title>Introduction</title><p>To study cerebrospinal fluid neurofilament light chain (CSF-NfL) levels as a prognostic biomarker in pediatric Guillain-Barré syndrome (GBS).</p></sec><sec><title>Methods</title><p>Prospective study enrolling 26 pediatric GBS patients and 48 healthy controls (HCs) from neurology units between 2017 to 2021. The CSF-NfL levels were measured by enzyme-linked immunosorbent assay. The children's disability levels were evaluated using Hughes Functional Score (HFS) at nadir, 1 month, and 6 months after onset. The receiver operating characteristic (ROC) curve derived from logistic regression (with age as a covariate) was used to assess the prognostic value of CSF-NfL on the possibility of walking aided at 1 month after symptom onset.</p></sec><sec><title>Results</title><p>The mean CSF-NfL levels were significantly increased in GBS patients (111.76 pg/mL) as compared to that in HCs (76.82 pg/mL) (<italic>t</italic> = 6.754, <italic>p</italic> &lt; 0.001). At follow- up, the mean CSF-NfL levels after treatment (65.69 pg/mL) declined significantly (<italic>t</italic> = 6.693, <italic>p</italic> &lt; 0.001). CSF-NfL levels upon admission were significantly associated with the HFS at nadir (<italic>r</italic><sub><italic>s</italic></sub> = 0.461, <italic>p</italic> = 0.018). Moreover, the mean CSF-NfL levels in GBS patients with poor prognosis (130.47pg/mL) were significantly higher than that in patients with good prognosis (104.87pg/mL) (<italic>t</italic> = 2.399, <italic>p</italic> = 0.025). ROC curve analysis of the predictive value of CSF-NfL levels with respect to the inability to walk unaided within 1 month showed a significant difference (area under the curve: 0.857,95% confidence interval 0.702-1.000; <italic>p</italic> = 0.006).</p></sec><sec><title>Conclusion</title><p>CSF-NfL levels were increased in pediatric GBS patients. High CSF-NfL level predicted worse motor function, and was strongly associated with poor short-term prognosis of pediatric GBS. We propose a biomarker for early prediction of outcome in pediatric GBS, which would be applicable for clinical practice and efficacy of treatment in the future.</p></sec>