Neurofilament light protein as a cerebrospinal fluid marker after whiplash trauma

The purpose was to investigate if a whiplash trauma may cause an increased concentration of the Neurofilament Light (NFL) protein, and if so; is this related to the injury severity and the radiological findings? Adult car occupants, with neck problems after rear-end collisions, were investigated in a study on Whiplash-Associated Disorders (WAD) in 1997-2001. The study protocol included a neurological examination, plain radiography and MRT of the cervical spine, and a lumbar puncture for Cerebrospinal Fluid (CSF) within six weeks after the accident. Similar CSF samples were also taken three and twelve months later. All CSF samples were analyzed for NFL. Of 52 subjects who entered the study, 43 completed it. The WAD grade was I in two of the 43 cases, II in 13, and III in 28. No one had radiological signs, indicating injuries to the cervical spine or spinal cord. Six subjects showed an increased NFL concentration at the primary examination. This was judged to be caused by whiplash trauma in three of them (7%). There was no relation between an increased NFL concentration and the number of pathological changes on plain radiographs or MRT. Neither was there a relation between the NFL concentration and the WAD grade. An increased NFL concentration can be found in some WAD patients. It might be difficult to relate such an increase to clinical or radiological findings. Further studies should investigate NFL as a marker for injuries to the central nervous system in whiplash trauma, including minimal traumatic brain injuries.