Deans' stroke musings: Circulating Neurofilament Light Predicts Cognitive Decline in Patients With Post-stroke Subjective Cognitive Impairment

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, June 7, 2021

Circulating Neurofilament Light Predicts Cognitive Decline in Patients With Post-stroke Subjective Cognitive Impairment

In what universe do you live where predicting cognitive decline is of any use to stroke survivors? Just maybe they want to recover from that cognitive decline. GET THERE!

Circulating Neurofilament Light Predicts Cognitive Decline in Patients With Post-stroke Subjective Cognitive Impairment

Jian-Hong Wang^1†,

Jie Huang^1†,

Fu-Qiang Guo¹,

Fang Wang²,

Shu Yang¹,

Neng-Wei Yu¹,

Bo Zheng³ and

Jian Wang^3*

¹Department of Neurology, The Affiliated Hospital of University of Electronic Science and Technology, Sichuan Provincial People’s Hospital, Chengdu, China
²Innovation Center of Nursing Research, West China Hospital, Nursing Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China
³Department of Neurology, Ya’an People’s Hospital, Ya’an, China

Background: Subjective cognitive impairment (SCI) is common after acute ischemic stroke and adversely affects the quality of life. SCI is associated with an increased risk of developing mild cognitive impairment and dementia. Identifying biomarkers which could predict long-term cognitive outcomes of post-stroke SCI is of importance for early intervention. This study aims to investigate the association between circulating neurofilament light (NfL) and long-term cognitive function in patients with post-stroke SCI.

Methods: This longitudinal study recruited 304 patients with post-stroke SCI, and serum NfL levels were determined at baseline. These patients were followed up for 12 months for the observation of cognitive change. Cognitive performances were assessed by a Chinese version of the Telephone Interview of Cognitive Status-40 (TICS-40) scale.

Results: The patients were divided into a progression group (as determined by decreased TICS-40 scores) and a stable group (as determined by increased or unchanged TICS-40 scores). The progression group had significantly higher serum NfL levels than the stable group at baseline. Serum NfL levels were predictive for longitudinal cognitive decline during follow-up.

Conclusion: These findings imply that circulating NfL could predict the long-term cognitive change of patients with post-stroke SCI.

Introduction

Subjective cognitive impairment (SCI) is a common complaint post-acute ischemic stroke (AIS), with a prevalence estimates ranging between 30 and 90% (Van Rijsbergen et al., 2014, 2019, 2020; Burns et al., 2019). SCI has been reported to be associated with an increased risk of progressing to objective cognitive impairment (OCI), including mild cognitive impairment (MCI) and dementia (Lee et al., 2020; Liew, 2020). Once the patients advanced to OCI stage, the quality of life would be adversely affected. Therefore, identifying post-stroke SCI individuals that are at risk of developing OCI is important for early intervention for long-term cognitive consequences. However, currently no or few reliable prognostic biomarkers are available to monitor the cognitive change of post-stroke SCI patients.

Neurofilament light (NfL) is a neuron-specific structural protein (Zetterberg, 2016), and NfL concentrations in cerebrospinal fluid could reflect the severity of neuronal damage (Khalil et al., 2018). Circulating NfL is suggested to be a reliable biomarker for monitoring the clinical trajectory of many types of neurodegenerative disease such as Parkinson’s disease (Mollenhauer et al., 2020) and Alzheimer’s disease (Mattsson et al., 2017). Recent evidence also demonstrated that NfL could serve as a prognostic marker of AIS (Tiedt et al., 2018; Pedersen et al., 2019). However, the predictive effects of circulating NfL for the long-term cognitive change of post-stroke SCI patients are not clear. In this study, we investigated the association between circulating NfL and the cognitive trajectory of post-stroke SCI patients.