Serum neurofilament light chain levels are associated with stroke severity and functional outcome in patients undergoing endovascular therapy for large vessel occlusion

Rahmig, Jan; Akgün, Katja; Simon, Erik; Gawlitza, Matthias; Hartmann, Christian; Siepmann, Timo; Pallesen, Lars-Peder; Barlinn, Jessica; Puetz, Volker; Ziemssen, Tjalf; Barlinn, Kristian

doi:10.1016/j.jns.2021.118063

Cited by 6 publications

(8 citation statements)

References 14 publications

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“…On another issue, it is still poorly explored what impact different types of acute treatment (i.e., MT and IVT alone or in combination) may have on brain-specific biomarkers 5 , 19 , 20 . Our preliminary results suggest that the use of IVT in addition to mechanical revascularization may be associated with lower biomarker levels compared to patients who received only MT, but larger confirmative studies are needed.…”

Section: Discussionmentioning

confidence: 99%

Serum β-synuclein, neurofilament light chain and glial fibrillary acidic protein as prognostic biomarkers in moderate-to-severe acute ischemic stroke

Barba,

Vollmuth,

Abu-Rumeileh

et al. 2023

Sci Rep

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We aimed to assess the prognostic value of serum β-synuclein (β-syn), neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) in patients with moderate-to-severe acute ischemic stroke. We measured β-syn, GFAP and NfL in serum samples collected one day after admission in 30 adult patients with moderate-to-severe ischemic stroke due to middle cerebral artery (MCA) occlusion. We tested the associations between biomarker levels and clinical and radiological scores (National Institute of Health Stroke Scale scores, NIHSS, and Alberta Stroke Program Early CT Score, ASPECTS), as well as measures of functional outcome (modified Rankin Scale, mRS). Serum biomarkers were significantly associated with ASPECTS values (β-syn p = 0.0011, GFAP p = 0.0002) but not with NIHSS scores at admission. Patients who received mechanical thrombectomy and intravenous thrombolysis showed lower β-syn (p = 0.029) und NfL concentrations (p = 0.0024) compared to patients who received only mechanical thrombectomy. According to median biomarker levels, patients with high β-syn, NfL or GFAP levels showed, after therapy, lower clinical improvement (i.e., lower 24-h NIHSS change), higher NIHSS scores during hospitalization and higher mRS scores at 3-month follow-up. Elevated serum concentrations of β-syn (p = 0.016), NfL (p = 0.020) or GFAP (p = 0.010) were significantly associated with 3-month mRS of 3–6 vs. 0–2 even after accounting for age, sex and renal function. In patients with moderate-to-severe acute ischemic stroke, serum β-syn, NfL and GFAP levels associated with clinical and radiological scores at different timepoints and were able to predict short- and middle-term clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Serum β-synuclein, neurofilament light chain and glial fibrillary acidic protein as prognostic biomarkers in moderate-to-severe acute ischemic stroke

Barba,

Vollmuth,

Abu-Rumeileh

et al. 2023

Sci Rep

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“…We conducted a preliminary sample size calculation in order to evaluate the correlation between biomarkers level after ischemic stroke and patient’s outcome: from literature we considered the correlation coefficients between sNfL and NIHSS score and between sNfL and mRS score as r = 0.50 and r = 0.45, respectively. 26 So, if we accept r = 0.45 (stricter situation) as expected correlation coefficient, with a power of 80% and a confidence level set at 95%, the required minimum sample size was of n = 36 patients. 27 Statistical analysis was performed using OriginLab, and SAS software [v. 9.4 SAS Institute Inc., Cary, USA].…”

Section: Methodsmentioning

confidence: 99%

Quantification and prospective evaluation of serum NfL and GFAP as blood-derived biomarkers of outcome in acute ischemic stroke patients

Ferrari

Rossi

Ricciardi

et al. 2023

J Cereb Blood Flow Metab

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Identification of reliable and accessible biomarkers to characterize ischemic stroke patients’ prognosis remains a clinical challenge. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are markers of brain injury, detectable in blood by high-sensitive technologies. Our aim was to measure serum NfL and GFAP after stroke, and to evaluate their correlation with functional outcome and the scores in rehabilitation scales at 3-month follow-up. Stroke patients were prospectively enrolled in a longitudinal observational study within 24 hours from symptom onset (D1) and monitored after 7 (D7), 30 ± 3 (M1) and 90 ± 5 (M3) days. At each time-point serum NfL and GFAP levels were measured by Single Molecule Array and correlated with National Institute of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), Trunk Control Test (TCT), Functional Ambulation Classification (FAC) and Functional Independence Measure (FIM) scores. Serum NfL and GFAP showed different temporal profiles: NfL increased after stroke with a peak value at D7; GFAP showed an earlier peak at D1. NfL and GFAP concentrations correlated with clinical/rehabilitation outcomes both longitudinally and prospectively. Multivariate analysis revealed that NfL-D7 and GFAP-D1 were independent predictors of 3-month NIHSS, TCT, FAC and FIM scores, with NfL being the biomarker with the best predictive performance.

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Section: Neurofilament Light Chain and Perioperative Strokementioning

confidence: 99%

“…Higher blood NfL levels before, immediately after EVT, and 24 h after EVT were associated death or disability at 90 days. Rahmig et al (2021) in their prospective study analyzed blood NfL levels in patients undergoing EVT for anterior circulation large vessel occlusion. The blood NfL level was serially measured before EVT and at 30 min, 6 h, 12 h, 24 h, 48 h, and 7 days after EVT.…”

Section: Neurofilament Light Chain and Perioperative Strokementioning

confidence: 99%

“…No differences existed among the serial blood NfL levels in the first 12 h post-EVT; however, a constant increase was observed afterward. Serum NfL may complement clinical and imaging predictors of treatment response and functional outcome in stroke patients undergoing EVT for anterior circulation large vessel occlusion (Rahmig et al, 2021). Alifier et al (2020) found that patients who had cardiac surgery had higher blood NfL levels than did patients who underwent other operations and that patients who experienced cardiopulmonary bypass had even higher levels.…”

Section: Neurofilament Light Chain and Perioperative Strokementioning

confidence: 99%

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Neurofilament Light Chain: A Candidate Biomarker of Perioperative Stroke

Zhang

Wang

et al. 2022

Front. Aging Neurosci.

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Perioperative stroke is defined as a brain infarction of ischemic or hemorrhagic etiology that occurs during surgery or within 30 days after surgery. However, identifying perioperative stroke is challenging. Thus, the discovery and validation of neurological biomarkers for perioperative stroke are urgently needed. Neurofilament forms part of the neuronal cytoskeleton and is exclusively expressed in neurons. After disease-related neuroaxonal damage occurs, neurofilament light chain protein is released into the cerebrospinal fluid and blood. Blood neurofilament light chain has recently been shown to serve as a potential marker of interest during the perioperative period. Therefore, the aim of the present review was to give an overview of the current understanding and knowledge of neurofilament light chain as a potential biomarker of perioperative stroke.

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Serum neurofilament light chain levels are associated with stroke severity and functional outcome in patients undergoing endovascular therapy for large vessel occlusion

Cited by 6 publications

References 14 publications

Serum β-synuclein, neurofilament light chain and glial fibrillary acidic protein as prognostic biomarkers in moderate-to-severe acute ischemic stroke

Serum β-synuclein, neurofilament light chain and glial fibrillary acidic protein as prognostic biomarkers in moderate-to-severe acute ischemic stroke

Quantification and prospective evaluation of serum NfL and GFAP as blood-derived biomarkers of outcome in acute ischemic stroke patients

Neurofilament Light Chain: A Candidate Biomarker of Perioperative Stroke

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