Robert Daniel Nass1, Katja Akgün2, Christian Elger3, Heinz Reichmann2, Marcus Wagner4, Rainer Surges3, Tjalf Ziemssen2. 1. Department of Epileptology, University Hospital Bonn, Bonn, Germany. Electronic address: daniel.nass@ukbonn.de. 2. Center of Clinical Neuroscience, Department of Neurology, Carl Gustav Carus University Hospital, Dresden, Germany. 3. Department of Epileptology, University Hospital Bonn, Bonn, Germany. 4. Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany.
Abstract
OBJECTIVE: It has been debated for decades whether single, self-limited seizures damage cerebral cells. Meanwhile, very sensitive measurements of biomarkers have become available, i.e. tau, neurofilament protein light (NFL), glial fibrillary acidic protein (GFAP) and ubiquitin carboxyterminate hydrolase L1 (UCHL-1), which we explored in this study. METHODS: Adult patients of the epilepsy monitoring unit were admitted to the study after written consent. Blood samples were drawn at baseline, immediately after a TCS and after two, six and 24 h. The markers were measured from frozen samples with a single-molecule array (SIMOA). RESULTS: 20 patients and 20 seizures were included. All markers showed subtle but significant postictal increases and returned to normal within the next few hours (p < 0.05). An increase of at least 100 % from baseline was noted in 30 % of patients for tau, 25 % for UCHL-1 and 15 % for GFAP, while NFL levels never increased above 100 %. Lactate was slightly correlated with the tau increase (r = 0.47, p = 0.037), leukocytes were correlated with postictal changes of GFAP (r = 0.68 p = 0.001). CONCLUSION: Our data supports the assumption that significant cerebral stress occurs in some but not all self-limited TCS. The postictal inflammatory response in particular seems to play an important role.
OBJECTIVE: It has been debated for decades whether single, self-limited seizures damage cerebral cells. Meanwhile, very sensitive measurements of biomarkers have become available, i.e. tau, neurofilament protein light (NFL), glial fibrillary acidic protein (GFAP) and ubiquitin carboxyterminate hydrolase L1 (UCHL-1), which we explored in this study. METHODS: Adult patients of the epilepsy monitoring unit were admitted to the study after written consent. Blood samples were drawn at baseline, immediately after a TCS and after two, six and 24 h. The markers were measured from frozen samples with a single-molecule array (SIMOA). RESULTS: 20 patients and 20 seizures were included. All markers showed subtle but significant postictal increases and returned to normal within the next few hours (p < 0.05). An increase of at least 100 % from baseline was noted in 30 % of patients for tau, 25 % for UCHL-1 and 15 % for GFAP, while NFL levels never increased above 100 %. Lactate was slightly correlated with the tau increase (r = 0.47, p = 0.037), leukocytes were correlated with postictal changes of GFAP (r = 0.68 p = 0.001). CONCLUSION: Our data supports the assumption that significant cerebral stress occurs in some but not all self-limited TCS. The postictal inflammatory response in particular seems to play an important role.
Authors: Eino Solje; Alberto Benussi; Emanuele Buratti; Anne M Remes; Annakaisa Haapasalo; Barbara Borroni Journal: Diagnostics (Basel) Date: 2021-04-27
Authors: Ahmed Abdelhak; Matteo Foschi; Samir Abu-Rumeileh; John K Yue; Lucio D'Anna; Andre Huss; Patrick Oeckl; Albert C Ludolph; Jens Kuhle; Axel Petzold; Geoffrey T Manley; Ari J Green; Markus Otto; Hayrettin Tumani Journal: Nat Rev Neurol Date: 2022-02-03 Impact factor: 44.711