Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Ernst-Grube Strasse 40, 06120, Halle (Saale), Germany.
Department of Neurology, University of Würzburg, Würzburg, Germany.
Sci Rep. 2023 Nov 28;13(1):20941. doi: 10.1038/s41598-023-47765-7.
We aimed to assess the prognostic value of serum β-synuclein (β-syn), neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) in patients with moderate-to-severe acute ischemic stroke. We measured β-syn, GFAP and NfL in serum samples collected one day after admission in 30 adult patients with moderate-to-severe ischemic stroke due to middle cerebral artery (MCA) occlusion. We tested the associations between biomarker levels and clinical and radiological scores (National Institute of Health Stroke Scale scores, NIHSS, and Alberta Stroke Program Early CT Score, ASPECTS), as well as measures of functional outcome (modified Rankin Scale, mRS). Serum biomarkers were significantly associated with ASPECTS values (β-syn p = 0.0011, GFAP p = 0.0002) but not with NIHSS scores at admission. Patients who received mechanical thrombectomy and intravenous thrombolysis showed lower β-syn (p = 0.029) und NfL concentrations (p = 0.0024) compared to patients who received only mechanical thrombectomy. According to median biomarker levels, patients with high β-syn, NfL or GFAP levels showed, after therapy, lower clinical improvement (i.e., lower 24-h NIHSS change), higher NIHSS scores during hospitalization and higher mRS scores at 3-month follow-up. Elevated serum concentrations of β-syn (p = 0.016), NfL (p = 0.020) or GFAP (p = 0.010) were significantly associated with 3-month mRS of 3-6 vs. 0-2 even after accounting for age, sex and renal function. In patients with moderate-to-severe acute ischemic stroke, serum β-syn, NfL and GFAP levels associated with clinical and radiological scores at different timepoints and were able to predict short- and middle-term clinical outcomes.
我们旨在评估血清β-突触核蛋白（β-syn）、神经丝轻链（NfL）和神经胶质纤维酸性蛋白（GFAP）在中重度急性缺血性脑卒中患者中的预后价值。我们测量了 30 名因大脑中动脉（MCA）闭塞而发生中重度缺血性脑卒中的成年患者入院后第 1 天采集的血清样本中的β-syn、GFAP 和 NfL。我们检测了生物标志物水平与临床和影像学评分（国立卫生研究院卒中量表评分，NIHSS 和阿尔伯塔卒中项目早期 CT 评分，ASPECTS）之间的关联，以及功能结局（改良 Rankin 量表，mRS）的测量。血清生物标志物与 ASPECTS 值显著相关（β-syn p = 0.0011，GFAP p = 0.0002），但与入院时的 NIHSS 评分无关。接受机械取栓和静脉溶栓的患者的β-syn（p = 0.029）和 NfL 浓度（p = 0.0024）低于仅接受机械取栓的患者。根据中位生物标志物水平，β-syn、NfL 或 GFAP 水平较高的患者在治疗后显示较低的临床改善（即 NIHSS 评分在 24 小时内变化较低）、住院期间 NIHSS 评分较高和 3 个月随访时 mRS 评分较高。血清β-syn（p = 0.016）、NfL（p = 0.020）或 GFAP（p = 0.010）浓度升高与 3 个月 mRS 为 3-6 分与 0-2 分显著相关，即使考虑到年龄、性别和肾功能也是如此。在中重度急性缺血性脑卒中患者中，血清β-syn、NfL 和 GFAP 水平与不同时间点的临床和影像学评分相关，并能够预测短期和中期临床结局。
