Neurology · Infectious Disease · 2 h ago
MRI Temporal Lobe Lesions and CSF Biomarkers Linked to Outcomes in Neuroinfection
A multicentre cohort study of 123 patients with neuroinfectious diseases found that MRI abnormalities and higher cerebrospinal fluid neuronal-injury biomarker levels were associated with poorer short-term outcomes. Temporal lobe involvement and a composite biomarker measure were independently associated with outcome at discharge; prospective studies are needed to validate their prognostic value.
- Temporal lobe involvement was associated with poorer discharge outcomes.
- CSF neuronal-injury markers were higher with MRI abnormalities.
- MRI patterns and composite biomarker burden contributed independently.
- Prospective validation is needed to establish prognostic value.
This multicentre cohort study assessed cerebrospinal fluid (CSF) biomarkers and MRI findings in 123 patients with neuroinfectious diseases and 95 non-neuroinflammatory controls. Investigators measured beta-synuclein, SNAP-25, neurogranin and neurofilament light chain (NfL), classified MRI lesion patterns, and evaluated functional outcome at discharge using the modified Rankin Scale and degree of recovery.
All four biomarkers were higher in patients with neuroinfectious disease and MRI abnormalities than in patients without MRI abnormalities and/or controls. Temporal lobe involvement was the MRI pattern most consistently associated with elevated biomarker levels, including after adjustment for aetiology. It was also independently associated with poor functional outcome and incomplete recovery. A global biomarker burden derived by principal component analysis improved outcome-model fit; both this measure and temporal lobe involvement remained independently associated with discharge outcome.
The findings suggest that MRI patterns and CSF markers capture complementary aspects of disease severity. The study assessed short-term outcomes in a cohort, and the authors note that prospective studies are needed to establish prognostic value; the results do not establish how these measures should guide clinical decisions.
In practice
In patients with neuroinfectious diseases, temporal lobe involvement on MRI and a composite measure of CSF neuronal-injury biomarkers were independently associated with functional outcome at discharge in this multicentre cohort. These findings support further evaluation of imaging and biomarker data as complementary prognostic information, but they do not establish validated prediction tools or show that using these measures to guide care improves outcomes. The evidence is limited to short-term outcomes; prospective studies are needed before their prognostic role is established.
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European Journal of Neurology: Convergence of Cerebrospinal Fluid Neuronal Biomarker Burden and MRI Lesion Pattern and Its Association With Short‐Term Outcome in Neuroinfectious Diseases ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.