Point-of-Care-Testing in Acute Stroke Management: An Unmet Need Ripe for Technological Harvest

Abstract

Stroke, the second highest leading cause of death, is caused by an abrupt interruption of blood to the brain. Supply of blood needs to be promptly restored to salvage brain tissues from irreversible neuronal death. Existing assessment of stroke patients is based largely on detailed clinical evaluation that is complemented by neuroimaging methods. However, emerging data point to the potential use of blood-derived biomarkers in aiding clinical decision-making especially in the diagnosis of ischemic stroke, triaging patients for acute reperfusion therapies, and in informing stroke mechanisms and prognosis. The demand for newer techniques to deliver individualized information on-site for incorporation into a time-sensitive work-flow has become greater. In this review, we examine the roles of a portable and easy to use point-of-care-test (POCT) in shortening the time-to-treatment, classifying stroke subtypes and improving patient’s outcome. We first examine the conventional stroke management workflow, then highlight situations where a bedside biomarker assessment might aid clinical decision-making. A novel stroke POCT approach is presented, which combines the use of quantitative and multiplex POCT platforms for the detection of specific stroke biomarkers, as well as data-mining tools to drive analytical processes. Further work is needed in the development of POCTs to fulfill an unmet need in acute stroke management.

Enhanced Colorimetric Signal for Accurate Signal Detection in Paper-Based Biosensors

“…Colorimetric detection puts to best use these important biosensors advantages. The current technologies that are based on colorimetric detection are mainly focused on point-of-care platforms, miniaturization of size, reduction of cost and without the incorporation of additional instruments [1][2][3]. A colorimetric sensor is based on the detection of analytes via a change in color that can be observed visually.…”

B-Type Natriuretic Peptide as a Significant Brain Biomarker for Stroke Triaging Using a Bedside Point-of-Care Monitoring Biosensor

“…The hidden information and technological advancements behind the utilization of biomarkers for stroke triaging are significant [ 48 , 49 , 50 ]. Stroke biomarkers can revolutionize the way that stroke patients are diagnosed, monitored, and how they recover [ 51 , 52 , 53 ]. Different biomarkers indicate different cascades and exhibit unique expression patterns that are connected to certain pathologies in the human body [ 46 , 54 , 55 ].…”

Blood-Based Biomarkers Are Associated with Different Ischemic Stroke Mechanisms and Enable Rapid Classification between Cardioembolic and Atherosclerosis Etiologies

“…Stroke is associated with several pathophysiological changes, which leads to the expression of different blood-based biomarker patterns [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. A biomarker is a small molecule that is usually a protein, which can be easily detected in biofluids (e.g., blood, plasma, saliva, and urine) and provide vital information on the condition of a specific organ, disease, or treatment [ 50 ]. An ideal biomarker is specific, sensitive, and selective.…”