Biomarker of early neurological deterioration in minor stroke and proximal large vessel occlusion: A pilot study
BackgroundPlasma neurofilament light chain (pNFL) represents one of the scaffolding proteins of central nervous system axonal injury. The aim of this study was to evaluate pNFL as a predictive biomarker for early neurological deterioration (END) in medically managed patients with large vessel occlus...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.1019530/full |
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| author | Zhiqiang Wang Zhiqiang Wang Shuai Wang Yuxia Li Rongyu Wang Lianyan Jiang Bo Zheng Yaodan Zhang Qingsong Wang Jian Wang |
| author_facet | Zhiqiang Wang Zhiqiang Wang Shuai Wang Yuxia Li Rongyu Wang Lianyan Jiang Bo Zheng Yaodan Zhang Qingsong Wang Jian Wang |
| author_sort | Zhiqiang Wang |
| collection | DOAJ |
| description | BackgroundPlasma neurofilament light chain (pNFL) represents one of the scaffolding proteins of central nervous system axonal injury. The aim of this study was to evaluate pNFL as a predictive biomarker for early neurological deterioration (END) in medically managed patients with large vessel occlusion (LVO) and mild presentation (NIHSS < 6).MethodsThis retrospective study was developed from a prospectively collected stroke database, which was conducted at a large academic comprehensive stroke center in western China. Patients who first presented with acute ischemic stroke (AIS) within 24 h of symptom onset were continuously included. Stroke severity was analyzed at admission using the NIHSS score. The pNFL drawn on admission was analyzed with a novel ultrasensitive single-molecule array.ResultsThirty-nine consecutive patients were included in the analysis, and 19 (48.72%) patients experienced END. Patients who experienced END had significantly higher pNFL levels (mean, 65.20 vs. 48.28 pg/mL; P < 0.001) and larger infarct volume (mean, 15.46 vs. 9.56 mL; P < 0.001). pNFL was valuable for the prediction of END (OR, 1.170; 95% CI, 1.049–1.306; P = 0.005), even after adjusted for age and sex (OR, 1.178; 95% CI, 1.038–1.323; P = 0.006), blood sampling time, baseline NIHSS, TOAST classification, and infarct volume (OR, 1.168; 95% CI, 1.034–1.320; P = 0.012). The area under the ROC curve was 85.0% (95% CI, 0.731–0.970; P < 0.001). The sensitivity was 73.7%, and the specificity was 80%.ConclusionEND in minor stroke with LVO was distinguishable from those without END following the determination of pNFL in the blood samples within 24 h of onset. The pNFL is a promising biomarker of END in minor stroke with LVO.Clinical trial registrationChiCTR1800020330. |
| first_indexed | 2024-04-11T19:40:58Z |
| format | Article |
| id | doaj.art-b8e4ff8352274ba388869833e31e4af2 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-11T19:40:58Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-b8e4ff8352274ba388869833e31e4af22022-12-22T04:06:43ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-10-011310.3389/fneur.2022.10195301019530Biomarker of early neurological deterioration in minor stroke and proximal large vessel occlusion: A pilot studyZhiqiang Wang0Zhiqiang Wang1Shuai Wang2Yuxia Li3Rongyu Wang4Lianyan Jiang5Bo Zheng6Yaodan Zhang7Qingsong Wang8Jian Wang9Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Neurology, Chengdu BOE Hospital, Chengdu, ChinaDepartment of Outpatient, The General Hospital of Western Theater Command, Chengdu, ChinaDepartment of Neurology, Chengdu BOE Hospital, Chengdu, ChinaDepartment of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Neurology, Ya'an People's Hospital, Ya'an, ChinaDepartment of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaDepartment of Neurology, The General Hospital of Western Theater Command, Chengdu, ChinaDepartment of Neurology, Ya'an People's Hospital, Ya'an, ChinaBackgroundPlasma neurofilament light chain (pNFL) represents one of the scaffolding proteins of central nervous system axonal injury. The aim of this study was to evaluate pNFL as a predictive biomarker for early neurological deterioration (END) in medically managed patients with large vessel occlusion (LVO) and mild presentation (NIHSS < 6).MethodsThis retrospective study was developed from a prospectively collected stroke database, which was conducted at a large academic comprehensive stroke center in western China. Patients who first presented with acute ischemic stroke (AIS) within 24 h of symptom onset were continuously included. Stroke severity was analyzed at admission using the NIHSS score. The pNFL drawn on admission was analyzed with a novel ultrasensitive single-molecule array.ResultsThirty-nine consecutive patients were included in the analysis, and 19 (48.72%) patients experienced END. Patients who experienced END had significantly higher pNFL levels (mean, 65.20 vs. 48.28 pg/mL; P < 0.001) and larger infarct volume (mean, 15.46 vs. 9.56 mL; P < 0.001). pNFL was valuable for the prediction of END (OR, 1.170; 95% CI, 1.049–1.306; P = 0.005), even after adjusted for age and sex (OR, 1.178; 95% CI, 1.038–1.323; P = 0.006), blood sampling time, baseline NIHSS, TOAST classification, and infarct volume (OR, 1.168; 95% CI, 1.034–1.320; P = 0.012). The area under the ROC curve was 85.0% (95% CI, 0.731–0.970; P < 0.001). The sensitivity was 73.7%, and the specificity was 80%.ConclusionEND in minor stroke with LVO was distinguishable from those without END following the determination of pNFL in the blood samples within 24 h of onset. The pNFL is a promising biomarker of END in minor stroke with LVO.Clinical trial registrationChiCTR1800020330.https://www.frontiersin.org/articles/10.3389/fneur.2022.1019530/fullbiomarkersearly neurological deteriorationlarge vessel occlusionminor strokeneurofilament light |
| spellingShingle | Zhiqiang Wang Zhiqiang Wang Shuai Wang Yuxia Li Rongyu Wang Lianyan Jiang Bo Zheng Yaodan Zhang Qingsong Wang Jian Wang Biomarker of early neurological deterioration in minor stroke and proximal large vessel occlusion: A pilot study Frontiers in Neurology biomarkers early neurological deterioration large vessel occlusion minor stroke neurofilament light |
| title | Biomarker of early neurological deterioration in minor stroke and proximal large vessel occlusion: A pilot study |
| title_full | Biomarker of early neurological deterioration in minor stroke and proximal large vessel occlusion: A pilot study |
| title_fullStr | Biomarker of early neurological deterioration in minor stroke and proximal large vessel occlusion: A pilot study |
| title_full_unstemmed | Biomarker of early neurological deterioration in minor stroke and proximal large vessel occlusion: A pilot study |
| title_short | Biomarker of early neurological deterioration in minor stroke and proximal large vessel occlusion: A pilot study |
| title_sort | biomarker of early neurological deterioration in minor stroke and proximal large vessel occlusion a pilot study |
| topic | biomarkers early neurological deterioration large vessel occlusion minor stroke neurofilament light |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.1019530/full |
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