Neurofilament light protein levels in cerebrospinal fluid predict long‐term disability of Guillain‐Barré syndrome: A pilot study

Objectives Although the recovery from Guillain‐Barré syndrome (GBS) is good in most patients, some develop permanent severe disability or even die. Early predictors would increase the likelihood to identify patients at risk for poor outcome at the acute stage, allowing them intensified therapeutic intervention. Materials and Method Eighteen patients with a history of GBS 9‐17 years ago were reassessed with scoring of neurological disability and quality of life assessment (QoL). Their previous diagnostic work‐up included clinical examination with scoring of disability, neurophysiological investigation, a battery of serology tests for infections, and cerebrospinal fluid (CSF) examination. Aliquots of CSF were frozen, stored for 20‐28 years, and analyzed by ELISA for determination of neurofilament light protein (NFL) and glial fibrillary acidic protein (GFAP). Results Patients with poor outcome (n = 3) had significantly higher NFL and GFAP levels at GBS nadir than those with good outcome (n = 15, P