{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:39:03Z","timestamp":1790991543277,"version":"4.1.0"},"reference-count":38,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T00:00:00Z","timestamp":1603324800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"accepted":{"date-parts":[[2020,9,25]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To validate sphingomyelin (SM) dosage in the cerebrospinal fluid (CSF) of patients affected by chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and Guillain-Barr\u00e9 syndrome (GBS) as a reliably assessable biomarker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively enrolled 184 patients from six Italian referral centres, in whom CSF SM levels were quantified by a fluorescence-based assay optimised and patented in our laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We confirmed increased levels of SM in the CSF of patients affected by typical CIDP (n=35), atypical CIDP (n=18) and acute inflammatory demyelinating polyradiculoneuropathy, AIDP (n=12) compared with patients affected by non-demyelinating neurological diseases, used as controls (n=85) (p&lt;0.0001, p\n                      <jats:italic>=<\/jats:italic>\n                      0.0065\u2009and p&lt;0.0001, respectively). In patients with CIDP classified for disease stage, SM was higher in active CIDP compared with both controls and stable CIDP (p&lt;0.0001), applying for a selective tool to treatment tailoring or withdrawal. SM was also increased in AIDP compared with axonal GBS, discerning the demyelinating from axonal variant of the disease. SM did not correlate with CSF protein levels, stratifying patients independently from commonly used CSF indexes, and displaying high specificity to avoid potential misdiagnosis. Finally, SM correlated with the main clinical scores and some neurophysiological parameters in patients with CIDP and AIDP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CSF SM is a diagnostic and staging wet biomarker for acquired demyelinating neuropathies and may effectively improve the management of patients affected by GBS and CIDP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnnp-2020-324445","type":"journal-article","created":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T17:22:32Z","timestamp":1603387352000},"page":"303-310","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["CSF sphingomyelin: a new biomarker of demyelination in the diagnosis and management of CIDP and GBS"],"prefix":"10.1136","volume":"92","author":[{"given":"Giovanna","family":"Capodivento","sequence":"first","affiliation":[{"name":"DINOGMI, University of Genoa, Genoa, Italy"},{"name":"UO Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3469-0113","authenticated-orcid":false,"given":"Chiara","family":"De Michelis","sequence":"additional","affiliation":[{"name":"DINOGMI, University of Genoa, Genoa, Italy"},{"name":"UO Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinella","family":"Carpo","sequence":"additional","affiliation":[{"name":"ASST Bergamo Ovest, Treviglio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Fancellu","sequence":"additional","affiliation":[{"name":"UO Neurologia, IRCCS Ospedale Policlinico San Martino, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3736-0048","authenticated-orcid":false,"given":"Erika","family":"Schirinzi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Severi","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Visigalli","sequence":"additional","affiliation":[{"name":"DINOGMI, University of Genoa, Genoa, Italy"},{"name":"UO Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3014-3913","authenticated-orcid":false,"given":"Diego","family":"Franciotta","sequence":"additional","affiliation":[{"name":"Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9478-3744","authenticated-orcid":false,"given":"Fiore","family":"Manganelli","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Siciliano","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Beronio","sequence":"additional","affiliation":[{"name":"Sant'Andrea Hospital, La Spezia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Capello","sequence":"additional","affiliation":[{"name":"DINOGMI, University of Genoa, Genoa, Italy"},{"name":"UO Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7561-7724","authenticated-orcid":false,"given":"Paola","family":"Lanteri","sequence":"additional","affiliation":[{"name":"Neurophysiology Center, IRCCS Istituto Neurologico Carlo Besta Foundation, Milan, 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