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Plasma neurofilament light admission levels and development of axonal pathology in mild traumatic brain injury.

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Hossain, Iftakher 
Mohammadian, Mehrbod 
Maanpää, Henna-Riikka 
Takala, Riikka SK 
Tenovuo, Olli 


BACKGROUND: It is known that blood levels of neurofilament light (NF-L) and diffusion-weighted magnetic resonance imaging (DW-MRI) are both associated with outcome of patients with mild traumatic brain injury (mTBI). Here, we sought to examine the association between admission levels of plasma NF-L and white matter (WM) integrity in post-acute stage DW-MRI in patients with mTBI. METHODS: Ninety-three patients with mTBI (GCS ≥ 13), blood sample for NF-L within 24 h of admission, and DW-MRI ≥ 90 days post-injury (median = 229) were included. Mean fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were calculated from the skeletonized WM tracts of the whole brain. Outcome was assessed using the Extended Glasgow Outcome Scale (GOSE) at the time of imaging. Patients were divided into CT-positive and -negative, and complete (GOSE = 8) and incomplete recovery (GOSE < 8) groups. RESULTS: The levels of NF-L and FA correlated negatively in the whole cohort (p = 0.002), in CT-positive patients (p = 0.016), and in those with incomplete recovery (p = 0.005). The same groups showed a positive correlation with mean MD, AD, and RD (p < 0.001-p = 0.011). In CT-negative patients or in patients with full recovery, significant correlations were not found. CONCLUSION: In patients with mTBI, the significant correlation between NF-L levels at admission and diffusion tensor imaging (DTI) measurements of diffuse axonal injury (DAI) over more than 3 months suggests that the early levels of plasma NF-L may associate with the presence of DAI at a later phase of TBI.


Acknowledgements: The authors thank our research nurses Patricia Bertenyi and Satu Honkala for their valuable contribution to this study.

Funder: The Finnish Medical Foundation

Funder: The Päivikki and Sakari Sohlberg Foundation

Funder: The Paulo Foundation

Funder: The Finnish Cultural Foundation

Funder: The Integra EANS Research Grant

Funder: University of Turku Graduate School funding

Funder: NIHR Research Professorship and the NIHR Cambridge BRC

Funder: NIHR Research UK (through a Senior Investigator Award and the Cambridge Biomedical Research Centre)

Funder: Academy of Medical Sciences / The Health Foundation Clinician Scientist Fellowship

Funder: personal grants from Emil Aaltonen Foundation sr

Funder: grants from the Swedish Research Council and the Swedish state under the agreement between the Swedish government and the County Councils, the ALF-agreement

Funder: Wallenberg Scholarship and grants from the Swedish and European Research Councils

Funder: Academy of Finland; doi:

Funder: Government’s Special Financial Transfer tied to academic research in Health Sciences (Finland)

Funder: Maire Taponen Foundation sr


Diffusion tensor imaging, Diffusion-weighted magnetic resonance imaging, Neurofilament light protein, Humans, Brain Concussion, Diffusion Tensor Imaging, Diffusion Magnetic Resonance Imaging, Intermediate Filaments, Brain, White Matter, Brain Injuries, Traumatic

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BMC Neurol

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Springer Science and Business Media LLC
European Commission (270259)