Prognostic Value of Investigating Neuron-Specific Enolase in Patients with Ischemic Stroke

Abstract

The aim of the study was to assess the prognostic value of the plasma neuron-specific enolase (NSE) level as a predictor of functional outcome and motor function recovery in the acute period of ischemic stroke (IS).Materials and Methods. Fifty patients with IS have been examined. On admission to the hospital and at 12-14 days after stroke onset, a clinical and neurological examination have been carried out with the supplementary quantitative assessment of neurological deficit severity according to the National Institutes of Health Stroke Scale (NIHSS), functional outcome according to the Modified Rankin Scale, and Rivermead Mobility Index. Enzyme immunoassay was used to determine NSE concentration in blood plasma in the acute period of the disease.Results. The NSE level in patients' blood plasma in the first 48 h after stroke onset positively correlates with the ischemic focus volume (r=0.49; p=0.003) and the severity of neurological symptoms (according to NIHSS) (r=0.33; p=0.02). NSE less than 2 ng/ml in the acute disease period is a predictor of good functional outcome 12-14 days after stroke onset (OR=12.4; р=0.006). The NSE level >2.6 ng/ml is associated with a high likelihood of lethal outcome.Neurological deficit below 15 according to NIHSS as well as the NSE level <2 ng/ml in the acute IS period are estimated as prognostic factors of significant recovery of motor function at 2 weeks after disease onset (OR=5.8; р=0.02).Conclusion. Determination of NSE in blood plasma makes it possible to predict functional outcome of the disease development and the recovery of motor function in patients with IS.

Biomarkers for prognostic functional recovery poststroke: A narrative review

“…NSE, also known as the γγ-isoenzyme of the glycolytic enzyme enolase, gets released into the extracellular matrix as a result of neuronal injury and death, and can be detected in blood shortly thereafter ( Kurakina et al, 2021 ; Shash et al, 2021 ). NSE has been used as a biomarker to assess the extent of structural and functional impairment in the central nervous system ( Kurakina et al, 2021 ).…”

“…NSE, also known as the γγ-isoenzyme of the glycolytic enzyme enolase, gets released into the extracellular matrix as a result of neuronal injury and death, and can be detected in blood shortly thereafter ( Kurakina et al, 2021 ; Shash et al, 2021 ). NSE has been used as a biomarker to assess the extent of structural and functional impairment in the central nervous system ( Kurakina et al, 2021 ). Although no consensus has been reached on the correlation between NSE level and the severity of neurological symptoms in stroke ( Kurakina et al, 2021 ), recent evidence supports its usefulness as a prognosis biomarker in stroke.…”

“…NSE has been used as a biomarker to assess the extent of structural and functional impairment in the central nervous system ( Kurakina et al, 2021 ). Although no consensus has been reached on the correlation between NSE level and the severity of neurological symptoms in stroke ( Kurakina et al, 2021 ), recent evidence supports its usefulness as a prognosis biomarker in stroke. NSE serum levels measured in samples taken shortly after symptom onset were high in patients with higher NIHSS scores measured 28 days after stroke ( Shash et al, 2021 ).…”

“…NSE serum levels measured in samples taken shortly after symptom onset were high in patients with higher NIHSS scores measured 28 days after stroke ( Shash et al, 2021 ). In a study following up patients for 90 days, high NSE levels were positively correlated with higher scores in the NIHSS and mRS ( Kurakina et al, 2021 ). A similar trend was observed in ischemic stroke patients in a study assessing functional recovery 60 days after stroke using the NIHSS ( González-García et al, 2012 ).…”

“…NSE levels positively correlated with functional outcomes assessed using the NIHSS and mRS at 14 days post-stroke ( Nasution and Bangun, 2022 ). In blood samples taken within the first 48 h after ischemic stroke, high NSE levels were correlated with the severity of neurological symptoms, assessed by the NIHSS ( Kurakina et al, 2021 ). On the other hand, low levels of NSE were associated with good motor function outcomes 2 weeks after symptom onset, suggesting that NSE is a good predictor of motor recovery, measured by the Rivermead mobility index ( Kurakina et al, 2021 ).…”