Serum neurofilament light chain in patients with acute cerebrovascular events
Male
610 Medicine & health
Middle Aged
Magnetic Resonance Imaging
Severity of Illness Index
10040 Clinic for Neurology
Brain Ischemia
3. Good health
Stroke
03 medical and health sciences
2728 Neurology (clinical)
0302 clinical medicine
Ischemic Attack, Transient
Neurofilament Proteins
2808 Neurology
Outcome Assessment, Health Care
Humans
Female
Prospective Studies
Aged
DOI:
10.1111/ene.13554
Publication Date:
2017-12-27T14:14:11Z
AUTHORS (20)
ABSTRACT
Background and purposeSerum neurofilaments are markers of axonal injury. We addressed their diagnostic and prognostic role in acute ischemic stroke (AIS) and transient ischemic attack (TIA).MethodsNested within a prospective cohort study, we compared levels of serum neurofilament light chain (sNfL) drawn within 24 h from symptom onset in patients with AIS or TIA. Patients without magnetic resonance imaging on admission were excluded. We assessed whether sNfL was associated with: (i) clinical severity on admission, (ii) diagnosis of AIS vs. TIA, (iii) infarct size on admission magnetic resonance diffusion‐weighted imaging (MR‐DWI) and (iv) functional outcome at 3 months.ResultsWe analyzed 504 patients with AIS and 111 patients with TIA. On admission, higher National Institutes of Health Stroke Scale (NIHSS) scores were associated with higher sNfL: NIHSS score < 7, 13.1 pg/mL [interquartile range (IQR), 5.3–27.8]; NIHSS score 7–15, 16.7 pg/mL (IQR, 7.4–34.9); and NIHSS score > 15, 21.0 pg/mL (IQR, 9.3–40.4) (P = 0.01). Compared with AIS, patients with TIA had lower sNfL levels [9.0 pg/mL (95% confidence interval, 4.0–19.0) vs. 16.0 pg/mL (95% confidence interval, 7.3–34.4), P < 0.001], also after adjusting for age and NIHSS score (P = 0.006). Among patients with AIS, infarct size on admission MR‐DWI was not associated with sNfL, either in univariate analysis (P = 0.15) or after adjusting for age and NIHSS score on admission (P = 0.56). Functional outcome 3 months after stroke was not associated with sNfL after adjusting for established predictors.ConclusionsIn conclusion, among patients admitted within 24 h of AIS or TIA onset, admission sNfL levels were associated with clinical severity on admission and TIA diagnosis, but not with infarct size on MR‐DWI acquired on admission or functional outcome at 3 months.
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