486 立方体隧道中血清神经丝轻链(NfL)的定量分析

Amanda Faust, Christopher Dy, David M. Brogan
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摘要

目标/目的:我们实验室的长期目标是开发临床和术中方法,帮助评估压迫性和创伤性周围神经病。本项目的总体目标是确定血清神经丝轻链作为神经损伤诊断生物标志物的潜力。方法/研究对象:这项前瞻性研究的目的是获取肘隧道综合征和创伤性神经损伤患者血清 NfL 水平的数据。将把肘管综合征和创伤性神经损伤患者的血清 NfL 与无症状、性别和年龄匹配的对照组的血清 NfL 进行比较。将测量肘隧道患者术前和术后的血清 NfL 水平,并将其与患者术前的体格检查结果、运动和感觉功能测试、电诊断研究、超声波检查、硬膜内血管的存在以及术后患者报告的疗效指标进行比较。对于创伤性神经损伤患者,将使用急性期和随后的血清 NfL 测量来评估 NfL 的时间变化。结果/预期结果:本研究的核心假设是,尺神经无症状性压迫或臂丛神经外伤导致轴突挛缩,将导致血清 NfL 出现可测量的增加,其增加程度与神经损伤程度成正比。这一假设是根据临床经验和已发表的研究结果提出的,这些研究结果表明,继发于不同形式周围神经病变的轴索损伤会导致血清 NfL 水平升高。讨论/意义:本项目的意义在于,对临床症状、非侵入性成像和 NfL 表达之间的关系进行定性,将为压迫性和创伤性周围神经病的治疗提供更好的诊断和预后算法。
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486 Quantification of serum neurofilament light chain (NfL) in cubital tunnel
OBJECTIVES/GOALS: The long-term goal of our lab is to develop clinical and intra-operative methods to aid in assessment of compressive and traumatic peripheral neuropathies. The overall objective of this project is toidentify the potential of serum neurofilament light chain as a diagnostic biomarker for nerve injury. METHODS/STUDY POPULATION: The objective of this prospective study is to obtain data on serum NfL levels in patients with cubital tunnel syndrome and traumatic nerve injuries. Serum NfL from patients with cubital tunnel and traumatic nerve injuries will be compared to serum NfL of asymptomatic, sex and aged matched controls. Pre-operative and post-operative serum levels will be measured and compared topatient’s pre-operative physical exam findings, motor and sensory function testing, electrodiagnostic studies, ultrasound, presence of intraneural vascularity, and post-operative patient reported outcome measures for cubital tunnel patients. For patients with traumatic nerve injury, acute phase and a subsequent serum NfL measurement will be used to assess temporal changes in NfL. RESULTS/ANTICIPATED RESULTS: The central hypothesis of this study is that symptomatic compression of the ulnar nerve or traumatic injury to the brachial plexus leading to axonotmesis will result in measurable increases in serum NfL proportional to the degree of nerve injury. This hypothesis has been formulated based on clinical experience and published studies demonstrating increased expression of serum NfL levels with axonal injury secondary to varying forms of peripheral neuropathy. DISCUSSION/SIGNIFICANCE: The significance of this project is that characterization of the relationship of clinical symptoms, non-invasive imaging and expression of NfL will lead to better diagnostic and prognostic algorithms in the treatment of compressive and traumatic peripheral neuropathies.
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