Serum neurofilament light chain in patients with acute cerebrovascular events

Background and purpose Serum neurofilaments are markers of axonal injury. We addressed their diagnostic and prognostic role in acute ischemic stroke (AIS) and transient ischemic attack (TIA). Methods Nested within a prospective cohort study, we compared levels of serum neurofilament light chain (sNf...

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Published in:European journal of neurology 2018-03, Vol.25 (3), p.562-568
Main Authors: De Marchis, G. M., Katan, M., Barro, C., Fladt, J., Traenka, C., Seiffge, D. J., Hert, L., Gensicke, H., Disanto, G., Sutter, R., Peters, N., Sarikaya, H., Goeggel‐Simonetti, B., El‐Koussy, M., Engelter, S., Lyrer, P. A., Christ‐Crain, M., Arnold, M., Kuhle, J., Bonati, L. H.
Format: Article
Language:English
Subjects:
Aged
biomarker
Brain Ischemia - blood
Brain Ischemia - diagnosis
Brain Ischemia - therapy
Cerebrovascular system
Chains
Confidence intervals
Diagnosis
Diagnostic systems
Female
Humans
Ischemia
Ischemic Attack, Transient - blood
Ischemic Attack, Transient - diagnosis
Ischemic Attack, Transient - therapy
Light levels
Magnetic Resonance Imaging
Male
Middle Aged
neurofilament light chain
Neurofilament Proteins - blood
Neurofilaments
outcome
Outcome Assessment (Health Care)
Patients
Prospective Studies
Resonance
Severity of Illness Index
Stroke
Stroke - blood
Stroke - diagnosis
Stroke - therapy
Transient ischemic attack
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Summary:Background and purpose Serum neurofilaments are markers of axonal injury. We addressed their diagnostic and prognostic role in acute ischemic stroke (AIS) and transient ischemic attack (TIA). Methods Nested within a prospective cohort study, we compared levels of serum neurofilament light chain (sNfL) drawn within 24 h from symptom onset in patients with AIS or TIA. Patients without magnetic resonance imaging on admission were excluded. We assessed whether sNfL was associated with: (i) clinical severity on admission, (ii) diagnosis of AIS vs. TIA, (iii) infarct size on admission magnetic resonance diffusion‐weighted imaging (MR‐DWI) and (iv) functional outcome at 3 months. Results We analyzed 504 patients with AIS and 111 patients with TIA. On admission, higher National Institutes of Health Stroke Scale (NIHSS) scores were associated with higher sNfL: NIHSS score < 7, 13.1 pg/mL [interquartile range (IQR), 5.3–27.8]; NIHSS score 7–15, 16.7 pg/mL (IQR, 7.4–34.9); and NIHSS score > 15, 21.0 pg/mL (IQR, 9.3–40.4) (P = 0.01). Compared with AIS, patients with TIA had lower sNfL levels [9.0 pg/mL (95% confidence interval, 4.0–19.0) vs. 16.0 pg/mL (95% confidence interval, 7.3–34.4), P < 0.001], also after adjusting for age and NIHSS score (P = 0.006). Among patients with AIS, infarct size on admission MR‐DWI was not associated with sNfL, either in univariate analysis (P = 0.15) or after adjusting for age and NIHSS score on admission (P = 0.56). Functional outcome 3 months after stroke was not associated with sNfL after adjusting for established predictors. Conclusions In conclusion, among patients admitted within 24 h of AIS or TIA onset, admission sNfL levels were associated with clinical severity on admission and TIA diagnosis, but not with infarct size on MR‐DWI acquired on admission or functional outcome at 3 months.
ISSN:1351-5101
1468-1331
DOI:10.1111/ene.13554