Serum neurofilament light chain levels are associated with early neurological deterioration in minor ischemic stroke
ObjectivesPatients with minor ischemic stroke (MIS) frequently suffer from early neurological deterioration (END) and become disabled. Our study aimed to explore the association between serum neurofilament light chain (sNfL) levels and END in patients with MIS.MethodsWe conducted a prospective obser...
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1096358/full |
| _version_ | 1811157774123401216 |
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| author | Jie Li Ping Zhang Yalan Zhu Yong Duan Shan Liu Jie Fan Hong Chen Chun Wang Xingyang Yi |
| author_facet | Jie Li Ping Zhang Yalan Zhu Yong Duan Shan Liu Jie Fan Hong Chen Chun Wang Xingyang Yi |
| author_sort | Jie Li |
| collection | DOAJ |
| description | ObjectivesPatients with minor ischemic stroke (MIS) frequently suffer from early neurological deterioration (END) and become disabled. Our study aimed to explore the association between serum neurofilament light chain (sNfL) levels and END in patients with MIS.MethodsWe conducted a prospective observational study in patients with MIS [defined as a National Institutes of Health Stroke Scale (NIHSS) score 0–3] admitted within 24 h from the onset of symptoms. sNfL levels were measured at admission. The primary outcome was END, defined as an increase in the NIHSS score by ≥2 points within 5 days after admission. Univariate and multivariate analyses were performed to explore the risk factors associated with END. Stratified analyses and interaction tests were conducted to identify variables that might modify the association between sNfL levels and END.ResultsA total of 152 patients with MIS were enrolled, of which 24 (15.8%) developed END. The median sNfL level was 63.1 [interquartile range (IQR), 51.2–83.4] pg/ml on admission, which was significantly higher than that of 40 age- and sex-matched healthy controls (median 47.6, IQR 40.8–56.1 pg/ml; p < 0.001). Patients with MIS with END had a higher level of sNfL (with ND: median 74.1, IQR 59.5–89.8 pg/ml; without END: median 61.2, IQR 50.5–82.2 pg/ml; p = 0.026). After adjusting for age, baseline NIHSS score, and potential confounding factors in multivariate analyses, an elevated sNfL level (per 10 pg/mL) was associated with an increased risk of END [odds ratio (OR) 1.35, 95% confidence interval (CI) 1.04–1.77; p = 0.027). Stratified analyses and interaction tests demonstrated that the association between sNfL and END did not change by age group, sex, baseline NIHSS score, Fazekas' rating scale, hypertension, diabetes mellitus, intravenous thrombolysis, and dual antiplatelet therapy in patients with MIS (all p for interaction > 0.05). END was associated with an increased risk of unfavorable outcomes (modified Rankin scale score ranging from 3 to 6) at 3 months.ConclusionEarly neurological deterioration is common in minor ischemic stroke and is associated with poor prognosis. The elevated sNfL level was associated with an increased risk of early neurological deterioration in patients with minor ischemic stroke. sNfL might be a promising biomarker candidate that can help to identify patients with minor ischemic stroke at high risk of neurological deterioration, for reaching individual therapeutic decisions in clinical practice. |
| first_indexed | 2024-04-10T05:13:00Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-10T05:13:00Z |
| publishDate | 2023-03-01 |
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| spelling | doaj.art-bf1b6ea21a4c4b9bb50981b5047f23b62023-03-09T06:51:21ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-03-011410.3389/fneur.2023.10963581096358Serum neurofilament light chain levels are associated with early neurological deterioration in minor ischemic strokeJie Li0Ping Zhang1Yalan Zhu2Yong Duan3Shan Liu4Jie Fan5Hong Chen6Chun Wang7Xingyang Yi8Department of Neurology, Deyang People's Hospital, Deyang, ChinaDepartment of Neurology, Deyang People's Hospital, Deyang, ChinaDepartment of Neurology, Guanghan People's Hospital, Deyang, ChinaDepartment of Neurology, Zhongjiang People's Hospital, Deyang, ChinaDepartment of Neurology, Deyang Jingyang District Hospital of Traditional Chinese Medicine, Deyang, ChinaDepartment of Neurology, Deyang Hospital of Integrated Traditional Chinese and Western Medicine, Deyang, ChinaDepartment of Neurology, Deyang People's Hospital, Deyang, ChinaDepartment of Neurology, Deyang People's Hospital, Deyang, ChinaDepartment of Neurology, Deyang People's Hospital, Deyang, ChinaObjectivesPatients with minor ischemic stroke (MIS) frequently suffer from early neurological deterioration (END) and become disabled. Our study aimed to explore the association between serum neurofilament light chain (sNfL) levels and END in patients with MIS.MethodsWe conducted a prospective observational study in patients with MIS [defined as a National Institutes of Health Stroke Scale (NIHSS) score 0–3] admitted within 24 h from the onset of symptoms. sNfL levels were measured at admission. The primary outcome was END, defined as an increase in the NIHSS score by ≥2 points within 5 days after admission. Univariate and multivariate analyses were performed to explore the risk factors associated with END. Stratified analyses and interaction tests were conducted to identify variables that might modify the association between sNfL levels and END.ResultsA total of 152 patients with MIS were enrolled, of which 24 (15.8%) developed END. The median sNfL level was 63.1 [interquartile range (IQR), 51.2–83.4] pg/ml on admission, which was significantly higher than that of 40 age- and sex-matched healthy controls (median 47.6, IQR 40.8–56.1 pg/ml; p < 0.001). Patients with MIS with END had a higher level of sNfL (with ND: median 74.1, IQR 59.5–89.8 pg/ml; without END: median 61.2, IQR 50.5–82.2 pg/ml; p = 0.026). After adjusting for age, baseline NIHSS score, and potential confounding factors in multivariate analyses, an elevated sNfL level (per 10 pg/mL) was associated with an increased risk of END [odds ratio (OR) 1.35, 95% confidence interval (CI) 1.04–1.77; p = 0.027). Stratified analyses and interaction tests demonstrated that the association between sNfL and END did not change by age group, sex, baseline NIHSS score, Fazekas' rating scale, hypertension, diabetes mellitus, intravenous thrombolysis, and dual antiplatelet therapy in patients with MIS (all p for interaction > 0.05). END was associated with an increased risk of unfavorable outcomes (modified Rankin scale score ranging from 3 to 6) at 3 months.ConclusionEarly neurological deterioration is common in minor ischemic stroke and is associated with poor prognosis. The elevated sNfL level was associated with an increased risk of early neurological deterioration in patients with minor ischemic stroke. sNfL might be a promising biomarker candidate that can help to identify patients with minor ischemic stroke at high risk of neurological deterioration, for reaching individual therapeutic decisions in clinical practice.https://www.frontiersin.org/articles/10.3389/fneur.2023.1096358/fullminor ischemic strokeneurological deteriorationneurofilament light chainodds ratiobiomarker |
| spellingShingle | Jie Li Ping Zhang Yalan Zhu Yong Duan Shan Liu Jie Fan Hong Chen Chun Wang Xingyang Yi Serum neurofilament light chain levels are associated with early neurological deterioration in minor ischemic stroke Frontiers in Neurology minor ischemic stroke neurological deterioration neurofilament light chain odds ratio biomarker |
| title | Serum neurofilament light chain levels are associated with early neurological deterioration in minor ischemic stroke |
| title_full | Serum neurofilament light chain levels are associated with early neurological deterioration in minor ischemic stroke |
| title_fullStr | Serum neurofilament light chain levels are associated with early neurological deterioration in minor ischemic stroke |
| title_full_unstemmed | Serum neurofilament light chain levels are associated with early neurological deterioration in minor ischemic stroke |
| title_short | Serum neurofilament light chain levels are associated with early neurological deterioration in minor ischemic stroke |
| title_sort | serum neurofilament light chain levels are associated with early neurological deterioration in minor ischemic stroke |
| topic | minor ischemic stroke neurological deterioration neurofilament light chain odds ratio biomarker |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1096358/full |
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