Elevated levels of cerebrospinal fluid S100B are associated with brain injury and unfavorable outcomes in children with central nervous system infections.

PURPOSE: This work aimed to assess whether elevated levels of cerebrospinal fluid (CSF) S100B are associated with brain injury and unfavorable outcomes at discharge in children with central nervous system (CNS) infections. METHODS: CSF S100B and associated clinical parameters were retrospectively analyzed in 83 children with CNS infections and 88 children without neurological pathology served as controls. Children with CNS infections were divided into an infectious encephalitis group and an infectious meningitis group based on whether cerebral parenchyma was involved, and CSF S100B levels in different age subgroups between the two groups were compared. The predictive value of CSF S100B in children with infectious encephalitis was evaluated by multivariate logistic regression analysis, and the discriminative power was investigated by receiver operating characteristic (ROC) analysis. RESULTS: CSF S100B levels in the infectious encephalitis group were significantly higher than the infectious meningitis and the control group at each age range. CSF S100B ≥ 0.96 µg/L had 62.9% sensitivity and 76.2% specificity for diagnosing cerebral parenchyma injury in children with CNS infections. Increased CSF S100B levels were proven to be an independent predictor of unfavorable outcomes in children with infectious encephalitis and the optimal cut-off value (1.77 µg/L of CSF S100B) for predicting unfavorable outcomes in children with infectious encephalitis showed 61.1% sensitivity and 96.2% specificity. CONCLUSIONS: This study has demonstrated that elevated levels of CSF S100B are associated with brain injury and could be used as an independent predictor of clinically unfavorable outcomes at discharge in children with CNS infections.

[Long-term behavioral and ultrastructural alterations following hypoxic-ischemic brain damage in neonatal rats].

OBJECTIVE: To study long-term behavioral and ultrastructural alterations in a hypoxic-ischemic brain damage (HIBD) model of neonatal rats. METHODS: Sixty seven-day-old Sprague-Dawley rats were randomly subjected to unilateral carotid artery ligation followed by hypoxic exposure (HIBD group) or sham operation (n=30 each). A battery of behavioral tests, including Morris water maze test and sensorimotor tests, were performed at a postnatal age of 5 weeks. Nissl staining was used for counting neurons. Transmission electron microscopy was used for observing synapse structures and measuring the thickness of the postsynaptic density area and the length of the postsynaptic active area. The correlations of histological changes with the results of behavioral tests were evaluated. RESULTS: The HIBD group showed a significantly longer escape latency (P<0.05) and a lower frequency of original platform crossing (P<0.05) in the Morris water maze test compared with the sham operation group. The sensorimotor function test showed that the sensorimotor function in the HIBD group was worse than in the sham operation group. Nissl staining showed that the number of neurons in the HIBD group was significantly reduced (P<0.01) compared with the sham operation group. Transmission electron microscopy showed that synapses were significantly reduced in number, and that the thickness of the postsynaptic density area and the length of the postsynaptic active area were reduced in the HIBD group. The thickness of the postsynaptic density area was negatively correlated with escape latency in the Morris water maze test (r=-0.861, P<0.01), and also negatively correlated with the total score of sensorimotor function tests (r=-0.758, P<0.05) in the HIBD group. CONCLUSIONS: Hypoxia ischemia can lead to neuron loss and ultrastructure damage, resulting in long-term deficit of behavioral functions in neonatal rats.

Comparison of the intervention methods for perinatal brain injury.

OBJECTIVE: To study the effective implementation of rehabilitation therapy for nervous system impairment in neonates with perinatal brain injury. METHODS: A retrospective case study of 160 neonates with perinatal brain injury was performed. The cases were assigned into 5 groups according to different treatment modalities. Group I included 42 babies aged below 6 months who were treated at early stages with neurotrophic agents and hyperbaric oxygenation with functional habilitation for more than 10 courses. Group II consisted of 30 babies who received the same treatments at the ages of 6 to 12 months. Group III (n=30) only received single-course therapy with medicine and high baric oxygen during neonatal period. Group IV(n=30) received medication only, while group V did not receive any nervous system rehabilitation therapy. Bayley Scale was used to evaluate the effect of the therapy in the 5 groups. RESULTS: Assessment with Bayley Scale revealed significant difference in the scores of development quotient (DQ) between the 5 groups, and group I scored the highest in gross movement, fine movement, self-care ability and communication/language (P<0.01). Groups III and IV had better scores in gross movement than group II and V (P<0.05), while no significant difference was noted in respect of any other score among groups II,III,IV and V. The DQ values of the 5 groups were significantly different (X(2)=56.674, P<0.001). CONCLUSION: Perinatal administration of neurotrophic agents and hyperbaric oxygenation along with functional habilitation therapy can effectively reduce nervous system sequelae of perinatal brain injury.