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@ARTICLE{AbuRumeileh:281642,
      author       = {Abu-Rumeileh, Samir and Erhart, Deborah K and Barba,
                      Lorenzo and Konen, Franz Felix and Stapf, Caroline and
                      Senel, Makbule and Hudasch, Dominica and Steinacker, Petra
                      and Oeckl, Patrick and Weise, Christopher M and Ticozzi,
                      Nicola and Halbgebauer, Steffen and Verde, Federico and
                      Sühs, Kurt-Wolfram and Tumani, Hayrettin and Otto, Markus},
      title        = {{CSF} {B}eta-{S}ynuclein, {SNAP}-25, and {N}eurogranin in
                      {I}nfectious and {A}utoimmune {I}nflammatory {N}eurologic
                      {D}iseases.},
      journal      = {Neurology: Neuroimmunology $\&$ Neuroinflammation ;
                      official journal of the American Academy of Neurology},
      volume       = {12},
      number       = {6},
      issn         = {2332-7812},
      address      = {Philadelphia, Pa.},
      publisher    = {Wolters Kluwer},
      reportid     = {DZNE-2025-01160},
      pages        = {e200491},
      year         = {2025},
      abstract     = {Beta-synuclein (beta-syn), synaptosomal-associated protein
                      25 (SNAP-25), and neurogranin are CSF biomarkers of synaptic
                      damage, which have been poorly investigated in
                      non-neurodegenerative neurologic diseases. In this study, we
                      examined the diagnostic and prognostic role of these markers
                      compared with the neuroaxonal damage marker neurofilament
                      light chain protein (NfL) in infectious and autoimmune
                      inflammatory neurologic diseases (IINDs and AINDs).This
                      cohort study included CSF samples from patients with
                      different etiologies of IIND (varicella-zoster virus, herpes
                      simplex virus, tick-borne meningoencephalitis, bacterial
                      meningitis/(meningo)encephalitis, neuroborreliosis, or
                      other/unknown etiology) or AIND (autoimmune encephalitis or
                      other etiology) as well as controls.A total of 123 patients
                      with IINDs (mean age 55.23 ± 18.04 years, $43.2\%$ female),
                      22 with AINDs (age 60.41 ± 16.03 years, $81.8\%$ female),
                      and 95 controls (age 52.39 ± 17.94 years, $56.9\%$ female)
                      were enrolled. Compared with the control group, participants
                      with IINDs and AINDs showed higher concentrations of
                      beta-syn (p < 0.001 and p = 0.038, respectively),
                      neurogranin (p = 0.039 and p = 0.002, respectively), and NfL
                      (p < 0.001 and p = 0.001, respectively), with no differences
                      between the 2 latter groups. Overall, synaptic markers and
                      NfL demonstrated poor-to-moderate diagnostic accuracy in
                      discriminating between diagnostic groups (area under the
                      curve 0.366-0.809). All synaptic biomarkers were elevated in
                      participants with IINDs presenting with altered mental
                      status (beta-syn, p < 0.001; SNAP-25, p = 0.002; and
                      neurogranin, p = 0.008), seizures (beta-syn, p = 0.013;
                      SNAP-25, p = 0.005; and neurogranin, p = 0.004), and
                      inflammatory changes on neuroimaging (beta-syn, p = 0.016;
                      SNAP-25, p = 0.029; and neurogranin, p = 0.007).
                      Participants with AINDs requiring intensive care showed
                      higher levels of beta-syn (p = 0.033) and NfL (p = 0.002).
                      Participants with IINDs with a poor functional status
                      (modified Rankin Scale [mRS] scores of 3-6) exhibited higher
                      concentrations of beta-syn (p < 0.001), SNAP-25 (p = 0.022),
                      neurogranin (p = 0.004), and NfL (p < 0.001) compared with
                      those with mRS scores of 0-2. Accordingly, higher levels of
                      synaptic markers were associated with poorer short-term
                      outcomes in patients with IINDs, but not in those with
                      AINDs.Elevated CSF levels of beta-syn, neurogranin, and NfL
                      may suggest a common pattern of synaptic and neuroaxonal
                      damage in both IINDs and AINDs. Although these biomarkers
                      have limited value in distinguishing between different
                      diseases, they are associated with clinical severity and
                      with short-term outcome, particularly in patients with
                      IINDs.},
      keywords     = {Humans / Female / Male / Middle Aged / Neurogranin:
                      cerebrospinal fluid / Aged / Biomarkers: cerebrospinal fluid
                      / Adult / Synaptosomal-Associated Protein 25: cerebrospinal
                      fluid / Autoimmune Diseases of the Nervous System:
                      cerebrospinal fluid / Autoimmune Diseases of the Nervous
                      System: diagnosis / Cohort Studies / Neuroinflammatory
                      Diseases: cerebrospinal fluid / Neuroinflammatory Diseases:
                      diagnosis / alpha-Synuclein: cerebrospinal fluid /
                      Encephalitis: cerebrospinal fluid / Encephalitis: diagnosis
                      / Neurofilament Proteins: cerebrospinal fluid / Neurogranin
                      (NLM Chemicals) / Biomarkers (NLM Chemicals) /
                      Synaptosomal-Associated Protein 25 (NLM Chemicals) / SNAP25
                      protein, human (NLM Chemicals) / SNCA protein, human (NLM
                      Chemicals) / alpha-Synuclein (NLM Chemicals) / Neurofilament
                      Proteins (NLM Chemicals) / neurofilament protein L (NLM
                      Chemicals)},
      cin          = {AG Öckl / Clinical Study Center (Ulm)},
      ddc          = {610},
      cid          = {I:(DE-2719)5000073 / I:(DE-2719)5000077},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41061183},
      doi          = {10.1212/NXI.0000000000200491},
      url          = {https://pub.dzne.de/record/281642},
}