Circulating neurofilament light in ischemic stroke: temporal profile and outcome prediction
Journal article, 2019

Background and purpose: Neurofilament light chain (NfL) is a marker of neuroaxonal damage. We aimed to study associations between serum NfL (sNfL) concentrations at different time points after ischemic stroke and outcomes. Methods: We prospectively included ischemic stroke cases (n = 595, mean age 59 years, 64% males) and assessed outcomes by both the modified Rankin Scale (mRS) and the NIH stroke scale (NIHSS) at 3 months and by mRS at 2 years. In a subsample, long-term (7-year) outcomes were also assessed by both mRS and NIHSS. We used the ultrasensitive single-molecule array assay to measure sNfL in the acute phase (range 1–14, median 4 days), after 3 months and 7 years in cases and once in controls (n = 595). Results: Acute-phase sNfL increased by the time to blood-draw and highest concentrations were observed at 3 months post-stroke. High sNfL associated to stroke severity and poor outcomes, and both associations were strongest for 3-month sNfL. After adjusting for age, previous stroke, stroke severity, and day of blood draw, 3-month sNfL was significantly associated to both outcomes at all time points (p < 0.01 throughout). For all main etiological subtypes, both acute phase and 3-month sNfL were significantly higher than in controls, but the dynamics of sNfL differed by stroke subtype. Conclusions: The results from this study inform on sNfL in ischemic stroke and subtypes over time, and show that sNfL predicts short- and long-term neurological and functional outcomes. Our findings suggest a potential utility of sNfL in ischemic stroke outcome prediction.

Cerebrovascular disease

Prognosis

Biomarkers

Stroke in young adults

Author

Annie Pedersen

University of Gothenburg

Sahlgrenska University Hospital

Tara M. Stanne

University of Gothenburg

Staffan Nilsson

Chalmers, Mathematical Sciences, Applied Mathematics and Statistics

University of Gothenburg

Sofia Klasson

University of Gothenburg

Lars Rosengren

University of Gothenburg

Lukas Holmegaard

University of Gothenburg

Katarina Jood

University of Gothenburg

Kaj Blennow

Sahlgrenska University Hospital

University of Gothenburg

Henrik Zetterberg

University of Gothenburg

University College London (UCL)

Sahlgrenska University Hospital

Christina Jern

Sahlgrenska University Hospital

University of Gothenburg

Journal of Neurology

0340-5354 (ISSN)

Vol. 266 11 2796-2806

Subject Categories

Neurology

DOI

10.1007/s00415-019-09477-9

PubMed

31375988

More information

Latest update

12/9/2020