Cerebrospinal fluid ubiquitin C-terminal hydrolase as a novel marker of neuronal damage after epileptic seizure

Abstract

Ubiquitin carboxy-terminal hydrolase (UCH-L1) has been established as a reliable and potential biomarker of neuronal damage after acute neurologic insults such as ischemic stroke, subarachnoid hemorrhage, and traumatic brain injury. The effects of seizures on UCH-L1 levels in cerebrospinal fluid (CSF) has not been investigated in epileptic patients. The aim of the present study was to evaluate whether CSF UCH-L1 levels are a reliable marker of brain damage from epileptic seizures. Thirty-three patients with epilepsy (mean age 45 years) participated. Twenty-five patients had generalized seizures and eight had partial seizures. CSF was sampled by lumbar puncture. The control samples were obtained from 23 adult patients on whom lumbar puncture was performed to exclude neurological disease. CSF UCH-L1 levels were determined using an enzyme-linked immunosorbent assay (ELISA) kit. Patients with epilepsy had significantly elevated CSF levels of UCH-L1 after seizures compared with controls (p<0.001). CSF UCH-L1 levels were significantly higher in patients with generalized seizures than in patients with partial seizures and controls (p<0.001). Moreover, patients with repetitive generalized tonic-clonic (GTC) seizures had higher CSF UCH-L1 levels than those with a single GTC seizure (p<0.001). CSF UCH-L1 levels in seizure patients showed strong correlation with severity of seizures (r=0.56) and seizure duration (r=0.77). Conversely, CSF UCH-L1 levels in seizure patients did not correlate with the age of patients, duration of epilepsy, age of first seizure, time from last seizure or number of seizures. Our results suggest that UCH-L1 may serve as a novel biomarker for neuronal damage after epileptic seizure.