Abstract
Background and Purpose: We studied serum neurofilaments diagnostic value in patients with acute ischemic
stroke (AIS) or TIA and evaluated any correlation with symptom severity, cerebral
infarction volume, aetiology, and clinical outcome. Methods: One hundred and thirty-six patients (101 with AIS, and 35 with TIA) were included.
Acute-phase serum neurofilament light chain (sNfL) was analyzed with a novel ultrasensitive
single molecule array (Simoa). Cerebral infarction volume was measured from brain
computed tomography in the subacute phase (>2 days). Stroke aetiology was defined
by trial of ORG 10172 in acute stroke treatment classification, severity by National
Institute of Health stroke scale (NIHSS) and the degree of disability by the Modified
Rankin Scale (mRS) after 90 days. Results: sNfL was markedly higher in patients with AIS (89.5 pg/mL [IQR: 44.7-195.3]) than
with TIA (25.2 pg/mL [IQR: 14.6-48.0]), P= <.001), also after adjusting for age, NIHSS, and stroke volume (P= .003). In receiver operating characteristic analysis, sNfL concentration greater
than or equal to 49 pg/mL proved to be the best cut-off value to differentiate between
patients with stroke and those with TIA (sensitivity of 73% and specificity of 80%).
sNfL concentration significantly correlated with cerebral infarction volume (r = .413,
P= <.001), this association remained significant after adjusting for established predictors
(P= .019). Patients with AIS due to cardioembolism or large artery atherosclerosis had
the highest sNfL concentrations. NIHSS on admission (r = .343, P = <.001) and mRS scores after 3 months (r = .306, P = .004) correlated with sNfL concentration, however functional outcome 3 months after
stroke was not associated with sNfL after adjusting for potential confounders. Conclusions: Cases with stroke were distinguishable from those with TIA following the determination
of sNfL in the blood samples. The presence and amount of axonal damage estimated by
sNfL correlated with the final cerebral infarction volume but was not predictive of
degree of disability.
Key Words
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Article info
Publication history
Published online: May 28, 2019
Accepted:
May 6,
2019
Received in revised form:
April 22,
2019
Received:
February 11,
2019
Footnotes
Funding: None.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.05.008
Copyright
© 2019 Elsevier Inc. All rights reserved.
