TY - JOUR

T1 - Serum neurofilament light levels are correlated to long-term neurocognitive outcome measures after cardiac arrest

AU - Nordstrom, Erik Blennow

AU - Lilja, Gisela

AU - Ullen, Susann

AU - Blennow, Kaj

AU - Friberg, Hans

AU - Hassager, Christian

AU - Kjaergaard, Jesper

AU - Mattsson-Carlgren, Niklas

AU - Moseby-Knappe, Marion

AU - Nielsen, Niklas

AU - Vestberg, Susanna

AU - Zetterberg, Henrik

AU - Cronberg, Tobias

PY - 2022

Y1 - 2022

N2 - Objective To explore associations between four methods assessing long-term neurocognitive outcome after out-of-hospital cardiac arrest and early hypoxic-ischemic neuronal brain injury assessed by the biomarker serum neurofilament light (NFL), and to compare the agreement for the outcome methods. Methods An explorative post-hoc study was conducted on survivor data from the international Target Temperature Management after Out-of-hospital Cardiac Arrest trial, investigating serum NFL sampled 48/72-hours post-arrest and neurocognitive outcome 6 months post-arrest. Results Among the long-term surviving participants (N = 457), serum NFL (n = 384) was associated to all outcome instruments, also when controlling for demographic and cardiovascular risk factors. Associations between NFL and the patient-reported Two Simple Questions (TSQ) were however attenuated when adjusting for vitality and mental health. NFL predicted results on the outcome instruments to varying degrees, with an excellent area under the curve for the clinician-report Cerebral Performance Category (CPC 1-2: 0.90). Most participants were classified as CPC 1 (79%). Outcome instrument correlations ranged from small (Mini-Mental State Examination [MMSE]-TSQ) to strong (CPC-MMSE). Conclusions The clinician-reported CPC was mostly related to hypoxic-ischemic brain injury, but with a ceiling effect. These results may be useful when selecting methods and instruments for clinical follow-up models.

AB - Objective To explore associations between four methods assessing long-term neurocognitive outcome after out-of-hospital cardiac arrest and early hypoxic-ischemic neuronal brain injury assessed by the biomarker serum neurofilament light (NFL), and to compare the agreement for the outcome methods. Methods An explorative post-hoc study was conducted on survivor data from the international Target Temperature Management after Out-of-hospital Cardiac Arrest trial, investigating serum NFL sampled 48/72-hours post-arrest and neurocognitive outcome 6 months post-arrest. Results Among the long-term surviving participants (N = 457), serum NFL (n = 384) was associated to all outcome instruments, also when controlling for demographic and cardiovascular risk factors. Associations between NFL and the patient-reported Two Simple Questions (TSQ) were however attenuated when adjusting for vitality and mental health. NFL predicted results on the outcome instruments to varying degrees, with an excellent area under the curve for the clinician-report Cerebral Performance Category (CPC 1-2: 0.90). Most participants were classified as CPC 1 (79%). Outcome instrument correlations ranged from small (Mini-Mental State Examination [MMSE]-TSQ) to strong (CPC-MMSE). Conclusions The clinician-reported CPC was mostly related to hypoxic-ischemic brain injury, but with a ceiling effect. These results may be useful when selecting methods and instruments for clinical follow-up models.

KW - Hypoxic-ischemic encephalopathy

KW - heart arrest

KW - cognitive impairment

KW - biomarker

KW - cardiovascular disease

KW - TARGETED TEMPERATURE MANAGEMENT

KW - QUALITY-OF-LIFE

KW - SUBJECTIVE COGNITIVE COMPLAINTS

KW - MENTAL-STATE-EXAMINATION

KW - SIMPLE QUESTIONS

KW - 33-DEGREES-C

KW - RESUSCITATION

KW - 36-DEGREES-C

KW - EPIDEMIOLOGY

KW - SURVIVORS

U2 - 10.1080/02699052.2022.2048693

DO - 10.1080/02699052.2022.2048693

M3 - Journal article

C2 - 35253570

VL - 36

SP - 800

EP - 809

JO - Brain Injury

JF - Brain Injury

SN - 0269-9052

IS - 6

ER -