Analysis of Brain Injury Biomarker Neurofilament Light and Neurodevelopmental Outcomes and Retinopathy of Prematurity Among Preterm Infants

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Abstract
Brain injury biomarkers neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) are specific peptides reflecting neuro-axonal injury and astroglia cell injury in the brain. NfL constitutes a part of the neuronal cytoskeleton and shows promise in evaluating acute and chronic severity and the course of neurodegenerative diseases, such as Alzheimer disease, Parkinson disease, and multiple sclerosis,1-3 as well as hypoxic and traumatic brain injuries.4,5 Data on NfL in the preterm infant are sparse. The protein has historically been measured in cerebrospinal fluid (CSF), but methodological advances now allow quantification of NfL in serum using single-molecule array (Simoa) technology, which strongly correlates with levels measured in the CSF.6 The brain-specific GFAP is located in the astroglia and is released after cell injury and death.7 GFAP exhibits clinical prognostic potential in adult brain injury, including traumatic injury and stroke,8,9 and neurodegenerative disorders.10 Elevated GFAP concentrations in neonates, in both serum and CSF, have been described in association with periventricular white matter injury, brain injury after extracorporeal membrane oxygenation, and in full-term infants with abnormal brain magnetic resonance imaging (MRI) and adverse neurodevelopmental outcome following asphyxia.11-15

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