Brain-Derived Protein Concentrations in the Cerebrospinal Fluid: Contribution of Trauma Resulting from Ventricular Drain Insertion
- 1 July 2013
- journal article
- Published by Mary Ann Liebert Inc in Journal of Neurotrauma
- Vol. 30 (13), 1205-1210
- https://doi.org/10.1089/neu.2012.2621
Abstract
In recent years, the measurement of biomarkers following neurotrauma assisted in improving outcome prediction and guiding therapy. The use of neuroproteins as diagnostic parameters requires a detailed knowledge of their dynamics in biological fluids for an appropriate interpretation. S100B is the most widely studied neuromarker, and its concentration in serum and cerebrospinal fluid (CSF) reflects the extent of brain damage. Neuron-specific enolase (NSE) is considered reflecting neuronal damage, while Beta-Trace is a lepto-meningeal protein used to diagnose CSF leakage. In five patients treated with an external ventricular drain (EVD) because of aneurysmal subarachnoid hemorrhage (SAH, n=3) or postinfectious hydrocephalus (n=2), an EVD exchange was performed 8 to 12 days after initial insertion. S100B and NSE were measured with the Cobas e411(®) electrochemiluminescence assay (Roche Diagnostics, Mannheim, Germany) and Beta-Trace with the BN Pro Spec(®) nephelometer (Dade Behring/Siemens, Germany) 1 h before EVD exchange, upon the insertion of the new drain, and 1, 3, 6, 12, 18, 24 and 48 h after EVD exchange. Before EVD exchange, S100B CSF concentrations were within the normal range in all patients (1.48 ± 0.37 μg/L), while NSE CSF concentrations were normal in four of five patients (6.51 ± 2.98 μg/L). Following EVD exchange, S100B and NSE CSF levels peaked significantly at 3 h after insertion of the new drain (S100B 39.02 ± 9.17 μg/L; NSE 54.80 ± 43.34 μg/L). S100B serum levels were slightly increased 6 to 24 h after EVD exchange. Beta-Trace concentrations in the CSF were not altered by EVD insertion. Our data demonstrate that EVD insertion results in a distinct increase of S100B and NSE concentrations in the CSF. Thus, the tampering of brain-derived protein concentrations in the CSF by diagnostic or therapeutic procedures has to be considered in the interpretation of neuromarker levels.Keywords
This publication has 26 references indexed in Scilit:
- CSF biomarkers for Alzheimer disease correlate with cortical brain biopsy findingsNeurology, 2012
- Shunt-Dependent Hydrocephalus Following Subarachnoid Hemorrhage Correlates with Increased S100B Levels in Cerebrospinal Fluid and SerumActa neurochirurgica. Supplement, 2012
- VI. Indications for Intracranial Pressure MonitoringJournal of Neurotrauma, 2007
- Inflicted Childhood Neurotrauma: New Insight into The Detection, Pathobiology, Prevention, and Treatment of Our Youngest Patients with Traumatic Brain InjuryJournal of Neurotrauma, 2007
- A Critical Analysis of the Role of the Neurotrophic Protein S100B in Acute Brain InjuryJournal of Neurotrauma, 2006
- Neuroproteomics in neurotraumaMass Spectrometry Reviews, 2006
- S100B in brain damage and neurodegenerationMicroscopy Research and Technique, 2003
- Purification and Chemical Characterization of β‐Trace Protein from Human Cerebrospinal Fluid: Its Identification as Prostaglandin D SynthaseJournal of Neurochemistry, 1993
- Clinical relevance of increased neuron-specific enolase concentration in cerebrospinal fluidClinica Chimica Acta; International Journal of Clinical Chemistry, 1988
- S-100 protein and calmodulin levels in cerebrospinal fluid after subarachnoid hemorrhageJournal of Neurosurgery, 1985