Convergence of Cerebrospinal Fluid Neuronal Biomarker Burden and MRI Lesion Pattern and Its Association With Short-Term Outcome in Neuroinfectious Diseases.
9 affiliations
- 1Department of Brain Sciences, Imperial College London, London, England, UK.
- 2Department of Stroke and Neuroscience, Charing Cross Hospital, Imperial College London Healthcare NHS Trust, London, England, UK.
- 3Department of Neurology, Ulm University Hospital, Ulm, Germany.
- 4Department of Neurology, Hannover Medical School, Hannover, Germany.
- 5Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
- 6German Center for Neurodegenerative Diseases (DZNE e.V.), Ulm, Germany.
- 7Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy.
- 8Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università Degli Studi di Milano, Milan, Italy.
- 9Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany.
Abstract
Background
Neuroinfectious diseases (NDs) are potentially treatable conditions associated with substantial morbidity, but their clinical course remains difficult to predict. While specific MRI patterns are characteristic of distinct aetiologies, their prognostic value remains poorly investigated. Cerebrospinal fluid (CSF) biomarkers of neuroaxonal and synaptic damage have been linked to clinical outcome. We investigated the association of CSF biomarkers and MRI findings with short-term outcome in NDs.Methods
In this multicentre cohort study, CSF was analysed in 123 patients with NDs and in 95 non-neuroinflammatory controls. Concentrations of beta-synuclein, SNAP-25, neurogranin and neurofilament light chain protein (NfL) were measured. MRI findings were classified by topography and lesion pattern. Clinical outcome at discharge was assessed using the modified Rankin Scale and degree of recovery.Results
All CSF biomarkers were higher in ND patients with MRI abnormalities than in those without MRI abnormalities and/or controls, also within the (meningo-)encephalitis group. Temporal lobe involvement was the MRI pattern most consistently associated with elevated CSF biomarkers, even after multivariable adjustment including aetiology, and was independently associated with poor functional outcome and incomplete recovery. A global neuronal biomarker burden derived by principal component analysis (PC1) improved the fit of outcome models including MRI lesion pattern, with both temporal lobe involvement and PC1 remaining independently associated with outcome at discharge.Conclusions
MRI lesion pattern and CSF biomarkers of synaptic and neuroaxonal damage were independently associated with short-term outcome in NDs, suggesting that they capture complementary aspects of disease severity. Prospective studies are needed to establish their prognostic value.
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BibTeX
@article{danna2026convergence,
title = {{Convergence of Cerebrospinal Fluid Neuronal Biomarker Burden and MRI Lesion Pattern and Its Association With Short-Term Outcome in Neuroinfectious Diseases.}},
author = {Lucio D'Anna and Deborah K Erhart and Franz Felix Konen and Christopher M Weise and Makbule Senel and Caroline Stapf and Dominica Hudasch and Petra Steinacker and Lorenzo Barba and Patrick Oeckl and Jonas Ranke and Nicola Ticozzi and Federico Verde and Steffen Halbgebauer and Thomas Skripuletz and Kurt-Wolfram Sühs and Hayrettin Tumani and Markus Otto and Samir Abu-Rumeileh},
journal = {European journal of neurology},
year = {2026},
month = nov,
doi = {10.1111/ene.70802},
url = {https://europepmc.org/article/MED/42969432},
note = {CC BY},
}
RIS
TY - JOUR
TI - Convergence of Cerebrospinal Fluid Neuronal Biomarker Burden and MRI Lesion Pattern and Its Association With Short-Term Outcome in Neuroinfectious Diseases.
AU - Lucio D'Anna
AU - Deborah K Erhart
AU - Franz Felix Konen
AU - Christopher M Weise
AU - Makbule Senel
AU - Caroline Stapf
AU - Dominica Hudasch
AU - Petra Steinacker
AU - Lorenzo Barba
AU - Patrick Oeckl
AU - Jonas Ranke
AU - Nicola Ticozzi
AU - Federico Verde
AU - Steffen Halbgebauer
AU - Thomas Skripuletz
AU - Kurt-Wolfram Sühs
AU - Hayrettin Tumani
AU - Markus Otto
AU - Samir Abu-Rumeileh
PY - 2026
DA - 2026/11/01
JO - European journal of neurology
DO - 10.1111/ene.70802
UR - https://europepmc.org/article/MED/42969432
AB - Background Neuroinfectious diseases (NDs) are potentially treatable conditions associated with substantial morbidity, but their clinical course remains difficult to predict. While specific MRI patterns are characteristic of distinct aetiologies, their prognostic value remains poorly investigated. Cerebrospinal fluid (CSF) biomarkers of neuroaxonal and synaptic damage have been linked to clinical outcome. We investigated the association of CSF biomarkers and MRI findings with short-term outcome in NDs.Methods In this multicentre cohort study, CSF was analysed in 123 patients with NDs and in 95 non-neuroinflammatory controls. Concentrations of beta-synuclein, SNAP-25, neurogranin and neurofilament light chain protein (NfL) were measured. MRI findings were classified by topography and lesion pattern. Clinical outcome at discharge was assessed using the modified Rankin Scale and degree of recovery.Results All CSF biomarkers were higher in ND patients with MRI abnormalities than in those without MRI abnormalities and/or controls, also within the (meningo-)encephalitis group. Temporal lobe involvement was the MRI pattern most consistently associated with elevated CSF biomarkers, even after multivariable adjustment including aetiology, and was independently associated with poor functional outcome and incomplete recovery. A global neuronal biomarker burden derived by principal component analysis (PC1) improved the fit of outcome models including MRI lesion pattern, with both temporal lobe involvement and PC1 remaining independently associated with outcome at discharge.Conclusions MRI lesion pattern and CSF biomarkers of synaptic and neuroaxonal damage were independently associated with short-term outcome in NDs, suggesting that they capture complementary aspects of disease severity. Prospective studies are needed to establish their prognostic value.
SN - 1351-5101
SN - 1468-1331
ER -