{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:40:40Z","timestamp":1790628040165,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,11,7]],"date-time":"2020-11-07T00:00:00Z","timestamp":1604707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A randomized trial of phenytoin in acute optic neuritis (ON) demonstrated a 30% reduction in retinal nerve fiber layer (RNFL) loss with phenytoin versus placebo. Here we present the corresponding serum neurofilament analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty\u2010six acute ON cases were randomized to receive phenytoin (4\u20136\u00a0mg\/kg\/day) or placebo for 3\u00a0months, and followed up for 6\u00a0months. Serum was collected at baseline, 3 and 6\u00a0months for analysis of neurofilament heavy chain (NfH) and neurofilament light chain (NfL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010four patients had blood sampling. Of these, 58 and 56 were available at 3\u00a0months, and 55 and 54 were available at 6\u00a0months for NfH and NfL, respectively. There was no significant correlation between serum NfH and NfL at the time points tested. For NfH, the difference in mean placebo \u2013 phenytoin was \u221244\u00a0pg\/ml at 3\u00a0months (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.019) and \u221227\u00a0pg\/ml at 6\u00a0months (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.234). For NfL, the difference was 1.4\u00a0pg\/ml at 3\u00a0months (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.726) and \u22121.6\u00a0pg\/ml at 6\u00a0months (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.766).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>At 3\u00a0months, there was a reduction in NfH, but not NFL, in the phenytoin versus placebo group, while differences at 6\u00a0months were not statistically significant. This suggests a potential neuroprotective role for phenytoin in acute ON, with the lower NfH at 3\u00a0months, when levels secondary to degeneration of the anterior visual pathway are still elevated, but not at 6\u00a0months, when levels have normalized.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14591","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T00:14:28Z","timestamp":1602720868000},"page":"587-594","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Neurofilament results for the phase II neuroprotection study of phenytoin in optic neuritis"],"prefix":"10.1111","volume":"28","author":[{"given":"R.","family":"Raftopoulos","sequence":"first","affiliation":[{"name":"University College London Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Kuhle","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Grant","sequence":"additional","affiliation":[{"name":"University College London Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Hickman","sequence":"additional","affiliation":[{"name":"Department of Neurology Royal Hallamshire Hospital Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. R.","family":"Altmann","sequence":"additional","affiliation":[{"name":"Medical Statistics Department London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Leppert","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Blennow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg M\u00f6lndal Sweden"},{"name":"Clinical Neurochemistry Laboratory Sahlgrenska University Hospital M\u00f6lndal Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Zetterberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg M\u00f6lndal Sweden"},{"name":"Clinical Neurochemistry Laboratory Sahlgrenska University Hospital M\u00f6lndal Sweden"},{"name":"Department of Neurodegenerative Disease UCL Queen Square Institute of Neurology Queen Square London UK"},{"name":"UK Dementia Research Institute at UCL London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Kapoor","sequence":"additional","affiliation":[{"name":"University College London Institute of Neurology London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Giovannoni","sequence":"additional","affiliation":[{"name":"Department of Neuroscience &amp; 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