ABSOLUTELY NOTHING here will help survivors recover. Biomarkers and predictions are just functions of the complete failure of the status quo in stroke recovery. CHANGE THAT FAILURE!
Acute Neurofilament Light Chain Plasma Levels Correlate With Stroke Severity and Clinical Outcome in Ischemic Stroke Patients
Helle H. Nielsen1,2,3, 
Catarina B. Soares1,2, Sofie S. Høgedal1, 
Jonna S. Madsen4,5, Rikke B. Hansen1,2, Alex A. Christensen1, Charlotte Madsen1, 
Bettina H. Clausen1,3, Lars Henrik Frich6,7, 
Matilda Degn8, Christian Sibbersen3,9 and 
Kate L. Lambertsen1,2,3,7*- 1Department of Neurology, Odense University Hospital, Odense, Denmark
- 2Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- 3BRIDGE - Brain Research – Inter Disciplinary Guided Excellence, Department of Clinical Research, Odense, Denmark
- 4Department of Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- 5Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- 6The Orthopaedic Research Unit, Department of Clinical Research, Odense, Denmark
- 7OPEN, Open Patient data Explorative Network, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- 8Pediatric Oncology Laboratory, Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
- 9Mental Health Services in the Region of Southern Denmark, Odense, Denmark
Background: Ischemic stroke causes
increased blood–brain barrier permeability and release of markers of
axonal damage and inflammation. To investigate diagnostic and prognostic
roles of neurofilament light chain (NF-L), we assessed levels of NF-L,
S100B, interleukin-6 (IL-6), E-selectin, vascular endothelial growth
factor-A (VEGF-A), vascular cell adhesion molecule-1 (VCAM-1), and
intercellular adhesion molecule-1 (ICAM-1) in patients with acute
ischemic stroke or transient ischemic attack (TIA) and healthy controls.
Methods: We studied neurofilament (NF)
expression in 2 cases of human postmortem ischemic stroke, representing
infarcts aged 3- to >7-days. In a prospective study, we measured
plasma NF-L and inflammatory markers <8 h of symptom onset and at 72 h
in acute ischemic stroke (n = 31), TIA (n = 9), and healthy controls (n
= 29). We assessed whether NF-L, S100B, and IL-6 were associated with
clinical severity on admission (Scandinavian Stroke Scale, SSS),
diagnosis of ischemic stroke vs. TIA, and functional outcome at 3 months
(modified Rankin Scale, mRS).
Results: NF expression increased in
ischemic neurons and in the infarcted brain parenchyma after stroke.
Plasma NF-L levels were higher in stroke patients than in TIA patients
and healthy controls, but IL-6 levels were similar. Higher acute NF-L
levels were associated with lower SSS scores at admission and higher mRS
scores at 3 months. No correlation was observed between NF-L and S100B,
NF-L and IL-6, nor between S100B or IL-6 and SSS or mRS. Compared to
controls, stroke patients had significantly higher VEGF-A and VCAM-1 at
<8 h that remained elevated at 72 h, with significantly higher VEGF-A
at <8 h; ICAM-1 was significantly increased at <8 h, while S100B
and E-selectin were unchanged.
Conclusions: Plasma NF-L levels, but not
IL-6 and S100B, were significant predictors of clinical severity on
admission and functional outcome at 3 months. Plasma NF-L is a promising
biomarker of functional outcome after ischemic stroke.
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