METHODS: We measured the serum concentrations of neurofilament light chain (sNfL) in 46 outpatients with an at least monthly occurrence (self-reported) of generalized tonic-clonic seizures in the six months prior to the study and in 49 patients who had been seizure free (self-reported) for at least one year. We assigned the patients with seizure activity into groups with moderate and high seizure frequency. We measured sNfL with a highly sensitive single molecule array (Simoa).
RESULTS: The majority (94 %) of all patients with epilepsy had sNfL values within the age adjusted reference ranges of our laboratory. Three patients with and three patients without seizure activity (each 3 %) showed elevated sNfL concentrations. Age adjusted sNfL concentrations did not differ significantly between patients with and without seizure activity in the total sample or in the female subgroup. In contrast, NfL concentrations were significantly higher in male patients with seizure activity and highest in the subgroup of those with high seizure activity, but were only above the reference range in two patients. sNfL concentrations did not differ between focal and generalized epilepsies and between genetic and structural etiologies.
CONCLUSIONS: The sNfL concentrations in patients with epilepsy and healthy patients did not differ significantly. The finding of higher sNfL concentrations in males with self-reported seizure activity should be viewed with utmost caution because the difference was small and only two male patients showed sNfL concentrations above the reference range.
方法:我们测量了在研究前6个月内至少每月发生一次(自我报告)全身性强直阵挛性癫痫发作的46例门诊患者和无癫痫发作(自我报告)至少一年的49例患者的血清神经丝轻链(sNfL)浓度。我们将癫痫发作活动的患者分为中度和高度癫痫发作频率的组。我们用高度敏感的单分子阵列(Simoa)测量sNfL。
结果:所有癫痫患者中大多数(94%)的sNfL值在我们实验室的年龄调整参考范围内。3名患者和3名没有癫痫发作活动的患者(各3%)显示sNfL浓度升高。在总样本或女性亚组中,有和没有癫痫发作活动的患者之间,年龄调整后的sNfL浓度没有显着差异。相比之下,NfL浓度在癫痫发作活动的男性患者中显著较高,在癫痫发作活动较高的亚组中最高,但仅在两名患者中高于参考范围。局灶性和全身性癫痫之间以及遗传和结构病因之间的sNfL浓度没有差异。
结论:癫痫患者和健康患者的sNfL浓度没有显著差异。在具有自我报告的癫痫发作活动的男性中,sNfL浓度较高的发现应非常谨慎,因为差异很小,只有两名男性患者显示sNfL浓度高于参考范围。