Deans' stroke musings: Prognostic performance of blood neurofilament light chain for functional outcomes in patients with ischemic stroke: a systematic review and meta-analysis

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. Did your doctor somehow miss the recovery protocol that Pedro Bach-y-Rita used to recover fully back in 1958 with only a partial brain?

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.

Tuesday, October 27, 2026

Prognostic performance of blood neurofilament light chain for functional outcomes in patients with ischemic stroke: a systematic review and meta-analysis

Prognosticating a problem with NO solution to recovery offered is a fireable offense in any business!

Prognostic performance of blood neurofilament light chain for functional outcomes in patients with ischemic stroke: a systematic review and meta-analysis

T
Tong Tong He
Bo Wang
J
Jing Wang
Meng Li ^*

Neurology Department, Cangzhou Central Hospital of Hebei Medical University, Cangzhou City, China

Abstract

Introduction:

This meta-analysis aimed to assess the association between blood neurofilament light chain (NfL) and functional outcomes in patients with ischemic stroke.

Methods:

PubMed, Web of Science, Embase, Cochrane Library, and the China National Knowledge Infrastructure database were searched from inception through March 15, 2026. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled to quantify the association between blood NfL and functional outcomes in patients with ischemic stroke. We pooled the area under the curve (AUC), sensitivity, and specificity; conducted meta-regression and sensitivity analyses; and assessed publication bias.

Results:

A total of 18 studies involving 3,448 patients were included in this meta-analysis. The pooled results demonstrated that blood NfL was associated with poor functional outcomes after ischemic stroke (OR = 1.78, 95% CI: 1.41–2.24, p < 0.001, I² = 87.5%, p < 0.01). The pooled AUC for blood NfL in predicting functional outcomes in patients with ischemic stroke was 0.79 (95% CI: 0.75–0.82), with 71% (95% CI: 62–79%) sensitivity and 74% (95% CI: 67–80%) specificity. Subgroup analyses and meta-regression revealed that participant age, sample size, study design, blood sample type, assay method, proportion of poor functional outcomes, blood sampling time, reperfusion therapy rate, National Institutes of Health Stroke Scale score, definition of poor functional outcome, and the proportion of large artery atherosclerosis were not identified as significant sources of heterogeneity. Sensitivity analysis indicated that the pooled estimate was robust. Begg’s test also showed no evidence of publication bias (p = 0.753), although Egger’s test suggested the presence of publication bias (p < 0.001). The trim-and-fill method showed that the overall effect of this meta-analysis was stable.

Conclusion:

This meta-analysis showed that elevated blood NfL levels may have prognostic value for functional outcomes in patients with ischemic stroke. However, given the substantial between-study heterogeneity and the presence of publication bias, these findings should be interpreted with caution.

Systematic review registration:

https://www.crd.york.ac.uk/PROSPERO/view/CRD420261297284, identifier PROSPERO (CRD420261297284).