Urinary nerve growth factor level is correlated with the severity of neurological impairment in patients with cerebrovascular accident

Abstract

normalized to the concentration of urinary creatinine (uNGF/Cr). RESULTSThe median (interquartile range) uNGF/Cr levels were significantly higher in patients, at 0.13 (0-1.04), than in normal subjects (undetectable). The uNGF/Cr levels correlated well with the severity of neurological impairment. Patients with none/minimal neurological impairment had no detectable uNGF/Cr level, like the controls. Patients with mild/moderate impairment had levels of 0.27 (0.09-0.8) and with severe impairment level of 1.53 (0.5-3.0) (both P < 0.001), significantly greater than that of none/ minimal impairment or controls. However, uNGF/Cr levels were not correlated with age, location of CVA, multiplicity of CVA, duration of CVA, urodynamic findings or the presence of urge urinary incontinence. CONCLUSIONSThe uNGF level is correlated with the severity of neurological impairment in patients with CVA but not with urge symptoms or urodynamic findings, suggesting elevated uNGF might be a result of the neurological lesion rather than lower urinary tract dysfunction in CVA.

Recent Investigations of Urinary Nerve Growth Factor as a Biomarker for Overactive Bladder Syndrome

“…In a recent study of urinary NGF levels in patients with cerebrovascular accident (CVA), NGF/Cr levels were found to be significantly higher in CVA patients than in normal subjects [27]. Urinary NGF/Cr levels correlated well with the severity of neurological impairment.…”

Increased serum nerve growth factor levels in patients with overactive bladder syndrome refractory to antimuscarinic therapy

“…However, not only patients with OAB can have an elevated urinary NGF level; NGF may also be increased in patients with IC/PBS21 and other lower urinary tract diseases such as urinary tract stone, bacterial infection, and urothelial tumor 22. In patients with cerebral vascular accident (CVA), the urinary NGF levels increased in accordance with severity of neurological impairment 23. With effective antimucarinic therapy, urinary NGF levels decreased with time, but remained significantly greater than the controls at 12 months 22, 24…”

Nerve growth factor release from the urothelium increases via activation of bladder C‐fiber in rats with cerebral infarction

“…Why does NGF increase in the bladder of CI rats? Urinary NGF levels have also been identified to correlate with the severity of neurological impairment after cerebrovascular accident . The circulating serum NGF levels may represent some of the sourcing of urinary NGF, via renal excretion .…”

“…Bladder NGF levels declined after an initial peak at 1 day following cerebral perfusion intervention in the rat . Higher level of urinary NGF in stroke patients was suspected to be attributed to increased circulating NGF which was produced in brain tissue after stroke according to the severity of neurological impairment . On the contrary, NGF produced in excess in the pathological bladders has a sensitizing influence on C‐fiber afferent nerves, leading to urgency and ultimately DO .…”