An innovative approach for the evaluation of prolonged disorders of consciousness using NF-L and GFAP biomarkers: a pivotal study

• Published in: Scientific reports Vol. 12; no. 1; p. 18446
• Main Authors: Coppola, L., Mirabelli, P., Baldi, D., Smaldone, G., Estraneo, A., Soddu, A., Grimaldi, A. M., Mele, G., Salvatore, Marco, Cavaliere, Carlo
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 02.11.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/378; 692/53; 692/617/375; Anisotropy; Biomarkers; Consciousness; Differential diagnosis; Glial Fibrillary Acidic Protein; Humanities and Social Sciences; Humans; Intermediate Filaments; multidisciplinary; Neuroimaging; Neuronal-glial interactions; Patients; Persistent Vegetative State - diagnostic imaging; Positron emission tomography; Science; Science (multidisciplinary); Sleep and wakefulness; Substantia alba; Unconsciousness
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-21930-w

Behavioral assessments during the clinical evaluation in prolonged disorders of consciousness patients could be not sufficient for a correct diagnosis and prognostication. To this aim, we used an innovative approach, involving the ultra-sensitive determination of biological markers, correlating them with imaging parameters to investigate the prolonged disorders of consciousness (pDoC).We assessed the serum concentration of neurofilament light chain(NF-L) and glial fibrillary acidic protein (GFAP) in pDoC (n = 16), and healthy controls (HC, n = 6) as well as several clinical imaging parameters such as Fractional Anisotropy (FA), Whole Brain SUV, and White Matter Hyperintensities volumes (WMH) using PET-MRI acquisition. As for differential diagnosis task, only the imaging WMH volume was able to discriminate between vegetative state/unresponsive wakefulness syndrome (VS/UWS), and minimally conscious state (MCS) patients ( p -value < 0.01), while all selected markers (both imaging and in vitro) were able to differentiate between pDoC patients and HC. At subject level, serum NF-L concentrations significantly differ according to clinical progression and consciousness recovery ( p -value < 0.01), highlighting a potential play for the longitudinal management of these patients.