Neurofilament Light in Serum and Cerebrospinal Fluid of Hip Fracture Patients with Delirium

Nathalie Bodd Halaas; Kaj Blennow; Ane-Victoria Idland; Torgeir Bruun Wyller; Johan Ræder; Frede Frihagen; Anne Cathrine Staff; Henrik Zetterberg; Leiv Otto Watne

doi:10.1159/000494754

Neurofilament Light in Serum and Cerebrospinal Fluid of Hip Fracture Patients with Delirium

Dement Geriatr Cogn Disord. 2018;46(5-6):346-357. doi: 10.1159/000494754. Epub 2018 Dec 6.

Authors

Nathalie Bodd Halaas^{1

2}, Kaj Blennow^{3

4}, Ane-Victoria Idland^{5

6}, Torgeir Bruun Wyller^{5

7}, Johan Ræder^{7

8}, Frede Frihagen⁹, Anne Cathrine Staff^{7

10}, Henrik Zetterberg^{3

4

11

12}, Leiv Otto Watne^{5

6}

Affiliations

¹ Oslo Delirium Research Group, Department of Geriatric Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway, n.b.halaas@psykologi.uio.no.
² Research Group for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Oslo, Norway, n.b.halaas@psykologi.uio.no.
³ Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.
⁴ Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
⁵ Oslo Delirium Research Group, Department of Geriatric Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁶ Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
⁷ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
⁸ Department of Anesthesiology, Oslo University Hospital, Oslo, Norway.
⁹ Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.
¹⁰ Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.
¹¹ Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom.
¹² UK Dementia Research Institute at UCL, London, United Kingdom.

PMID: 30522125
DOI: 10.1159/000494754

Abstract

Background: Delirium is associated with new-onset dementia, suggesting that delirium pathophysiology involves neuronal injury. Neurofilament light (NFL) is a sensitive biomarker for neuroaxonal injury.

Methods: NFL was measured in cerebrospinal fluid (CSF) (n = 130), preoperative serum (n = 192), and postoperative serum (n = 280) in hip fracture patients, and in CSF (n = 123) and preoperative serum (n = 134) in cognitively normal older adults undergoing elective surgery. Delirium was diagnosed with the Confusion Assessment Method.

Results: Median serum NFL (pg/mL) was elevated in delirium in hip fracture patients (94 vs. 54 pre- and 135 vs. 92 postoperatively, both p < 0.001). Median CSF NFL tended to be higher in hip fracture patients with delirium (1,804 vs. 1,636, p = 0.074). Serum and CSF NFL were positively correlated (ρ = 0.56, p < 0.001).

Conclusion: Our findings support an association between neuroaxonal injury and delirium. The correlation between serum and CSF NFL supports the use of NFL as a blood biomarker in future delirium studies.

Keywords: Blood and cerebrospinal fluid biomarker; Delirium; Dementia; Neuroaxonal injury.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Biomarkers / blood
Biomarkers / cerebrospinal fluid
Correlation of Data
Delirium* / blood
Delirium* / cerebrospinal fluid
Delirium* / diagnosis
Delirium* / etiology
Dementia / diagnosis*
Female
Fracture Fixation / adverse effects*
Fracture Fixation / methods
Geriatric Assessment / methods
Hip Fractures* / psychology
Hip Fractures* / surgery
Humans
Male
Middle Aged
Neurofilament Proteins / blood
Neurofilament Proteins / cerebrospinal fluid*
Postoperative Complications* / blood
Postoperative Complications* / cerebrospinal fluid
Postoperative Complications* / diagnosis

Substances

Biomarkers
Neurofilament Proteins
neurofilament protein L