Biomarkers in Neurocritical Care

Kimberly, W. Taylor

doi:10.1007/s13311-011-0089-2

Cited by 4 publications

(4 citation statements)

References 81 publications

(77 reference statements)

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“…Our goal was to apply this new systematic tool as a first step to better understanding the biology and pathogenesis of acute ischemic stroke. In doing so, we also explored whether these candidates might serve as potential biomarkers for diagnosis or prognosis 11–13 .…”

Section: Introductionmentioning

confidence: 99%

Metabolite Profiling Identifies a Branched Chain Amino Acid Signature in Acute Cardioembolic Stroke

Kimberly

Wang

Pham

et al. 2013

Stroke

Self Cite

112

107

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Background There is limited information about changes in metabolism during acute ischemic stroke. The identification of changes in circulating plasma metabolites during cerebral infarction may provide insight into disease pathogenesis and identify novel biomarkers. Methods We performed filament occlusion of the middle cerebral artery of Wistar rats and collected plasma and cerebrospinal fluid (CSF) two hours after the onset of ischemia. Plasma samples from control and acute stroke patients were also analyzed. All samples were examined using liquid chromatography followed by tandem mass spectrometry. Positively charged metabolites including amino acids, nucleotides and neurotransmitters were quantified using electrospray ionization followed by scheduled multiple reaction monitoring. Results The concentrations of several metabolites were altered in the setting of cerebral ischemia. We detected a reduction in the branched chain amino acids (BCAA; valine, leucine, isoleucine) in rat plasma, rat CSF and human plasma compared to respective controls (16%, 23% and 17%, respectively; p<0.01 for each). In patients, lower BCAA levels also correlated with poor neurological outcome (mRS 0–2 versus 3–6, p=0.002). Conclusions BCAA are reduced in ischemic stroke, and the degree of reduction correlates with worse neurological outcome. Whether BCAA are in a causal pathway or are an epiphenomenon of ischemic stroke remains to be determined.

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Section: Introductionmentioning

confidence: 99%

Metabolite Profiling Identifies a Branched Chain Amino Acid Signature in Acute Cardioembolic Stroke

Kimberly

Wang

Pham

et al. 2013

Stroke

Self Cite

112

107

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“…141 Whereas many candidate biomarkers have been evaluated for ischemic stroke, 142 a smaller subset have potential application in large infarctions and swelling. 143 Biomarkers for cerebral swelling can be broadly categorized into neuroimaging modalities, serum markers, or continuous neuromonitoring techniques.…”

Section: Biomarkersmentioning

confidence: 99%

Recommendations for the Management of Cerebral and Cerebellar Infarction With Swelling

Wijdicks¹,

Sheth²,

Carter³

et al. 2014

Stroke

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429

204

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“…However, there is now a significant set of data showing that predicting outcomes based on physiological measurements is highly challenging. [155][156][157][158] 6.1 Sources and sinks Glucose enters the brain from the bloodstream via the Glucose Transporter 1 (GLUT1) carrier protein that is embedded within the blood-brain barrier. The kinetics of this transport process have been well-described and defined in the literature.…”

Section: Glucosementioning

confidence: 99%

A review of flux considerations for in vivo neurochemical measurements

Paul

Stenken

2015

Analyst

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The mass transport or flux of neurochemicals in the brain and how this flux affects chemical measurements and their interpretation is reviewed. For all endogenous neurochemicals found in the brain, the flux of each of these neurochemicals exists between sources that produce them and the sites that consume them all within μm distances. Principles of convective-diffusion are reviewed with a significant emphasis on the tortuous paths and discrete point sources and sinks. The fundamentals of the primary methods of detection, microelectrodes and microdialysis sampling of brain neurochemicals are included in the review. Special attention is paid to the change in the natural flux of the neurochemicals caused by implantation and consumption at microelectrodes and uptake by microdialysis. The detection of oxygen, nitric oxide, glucose, lactate, and glutamate, and catecholamines by both methods are examined and where possible the two techniques (electrochemical vs. microdialysis) are compared. Non-invasive imaging methods: magnetic resonance, isotopic fluorine MRI, electron paramagnetic resonance, and positron emission tomography are also used for different measurements of the above-mentioned solutes and these are briefly reviewed. Although more sophisticated, the imaging techniques are unable to track neurochemical flux on short time scales, and lack spatial resolution. Where possible, determinations of flux using imaging are compared to the more classical techniques of microdialysis and microelectrodes.

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Biomarkers in Neurocritical Care

Cited by 4 publications

References 81 publications

Metabolite Profiling Identifies a Branched Chain Amino Acid Signature in Acute Cardioembolic Stroke

Metabolite Profiling Identifies a Branched Chain Amino Acid Signature in Acute Cardioembolic Stroke

Recommendations for the Management of Cerebral and Cerebellar Infarction With Swelling

A review of flux considerations for in vivo neurochemical measurements

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