Cerebrospinal Fluid Levels of Brain Derived Neurotrophic Factor in Children with Acute Encephalitis Syndrome: A Prospective Observational Study

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Introduction: Acute Encephalitis Syndrome (AES) is a severe neurological condition affecting children, characterised by acute onset of fever, altered consciousness, and seizures, often leading to long-term complications or death. Brain Derived Neurotrophic Factor (BDNF) is a neurotrophin involved in neuronal survival, development, and repair, as well as in the brain’s response to injury and inflammation. Although BDNF has been studied in other neurological conditions, its role in AES remains largely unexplored. Aim: To assess BDNF in the Cerebrospinal Fluid (CSF) of children diagnosed with AES to explore its potential role in disease pathophysiology. Materials and Methods: This prospective observational study was conducted at the Department of Paediatrics at King George’s Medical University, Lucknow, Uttar Pradesh, India, from October 2022 to April 2024. Children aged six months to ≤12 years diagnosed with AES as per World Health Organisation (WHO) criteria were enrolled in the study. A detailed history, demographic data and examination, including blood investigations and neuroimaging {Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) Brain} were performed as needed for patients. CSF BDNF levels were measured using Enzyme Linked Immunosorbent Assay (ELISA). Outcomes were categorised as good or bad based on clinical status at discharge. Data were entered into a Microsoft Excel spreadsheet and were analysed using the statistical software Statistical Package for the Social Sciences (SPSS) version 23.0. For the comparative data, t-test and Chi-square test were applied. The difference in p-value<0.05 was considered statistically significant. Results: The present study evaluated 80 paediatric cases of AES with a mean age of 7.95±3.59 years, of which 48 cases (60%) had an unknown aetiology, 25 cases (31.25%) had bacterial infections, and 7 cases (8.75%) had viral infections. No significant differences were found in clinical symptoms, laboratory investigations, or CSF BDNF levels across the groups. Although most children had favourable outcomes (71.25%), there were minor differences in neurological signs, such as absent deep tendon reflexes in bacterial cases. The duration of hospital stay and recovery, as reflected by GCS scores, was similar across all groups. Conclusion: The present study found no significant difference in BDNF levels across different AES aetiologies or clinical outcomes. However, BDNF's potential as a neuroprotective agent in AES remains promising, warranting further research to explore its therapeutic applications.