Postanoxic electrographic status epilepticus and serum biomarkers of brain injury

Research output: Contribution to journalArticle

Abstract

Aim: To explore if electrographic status epilepticus (ESE) after cardiac arrest causes additional secondary brain injury reflected by serum levels of two novel biomarkers of brain injury: neurofilament light chain (NfL) originating from neurons and glial fibrillary acidic protein (GFAP) from glial cells. Methods: Simplified continuous EEG (cEEG) and serum levels of NfL and GFAP, sampled at 24, 48 and 72 h after cardiac arrest, were collected during the Target Temperature Management (TTM)-trial. Two statistical methods were used: multivariable regresssion analysis; and a matched control group of patients without ESE matched for early predictors of poor neurological outcome. Results: 128 patients had available biomarkers and cEEG. Twenty-six (20%) patients developed ESE, the majority (69%) within 24 h. ESE was an independent predictor of elevated serum NfL (p < 0.001) but not of serum GFAP (p = 0.16) at 72 h after cardiac arrest. Compared to a control group matched for early predictors of poor neurological outcome, patients who developed ESE had higher levels of serum NfL (p = 0.03) and GFAP (p = 0.04) at 72 h after cardiac arrest. Conclusion: ESE after cardiac arrest is associated with higher levels of serum NfL which may suggest increased secondary neuronal injury compared to matched patients without ESE but similar initial brain injury. Associations with GFAP reflecting glial injury are less clear. The study design cannot exclude imperfect matching or other mechanisms of secondary brain injury contributing to the higher levels of biomarkers of brain injury seen in the patients with ESE.

Details

Authors
Organisations
External organisations
  • Skåne University Hospital
  • Helsingborg Hospital
  • Sahlgrenska University Hospital
  • University College London
  • University of Gothenburg
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Anesthesiology and Intensive Care
  • Neurology

Keywords

  • Biomarkers, Cardiac arrest, EEG, Electrographic status epilepticus, Seizures
Original languageEnglish
Pages (from-to)253-257
Number of pages5
JournalResuscitation
Volume158
Early online date2020 Oct 27
Publication statusPublished - 2021 Jan 1
Publication categoryResearch
Peer-reviewedYes