Barba Lorenzo, Vollmuth Christoph, Halbgebauer Steffen, Ungethüm Kathrin, Hametner Christian, Essig Fabian, Kollikowski Alexander M, Pham Mirko, Schuhmann Michael K, Heuschmann Peter U, Oeckl Patrick, Steinacker Petra, Romoli Michele, D'Anna Lucio, Abu-Rumeileh Samir, Haeusler Karl Georg, Stoll Guido, Neugebauer Hermann, Otto Markus
Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany.
Department of Neurology, University Hospital Würzburg (UKH), Würzburg, Germany.
Eur J Neurol. 2025 Jan;32(1):e16581. doi: 10.1111/ene.16581.
We aimed to investigate the prognostic role of β-synuclein in comparison to that of neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) for predicting functional outcome after acute ischemic stroke (AIS).
We measured serum concentrations of β-synuclein, NfL and GFAP 24 h after hospital admission in 213 consecutive patients with moderate-to-severe AIS. We investigated the association between serum biomarkers and radiological/clinical characteristics, 3-months mortality and functional outcome on the modified Rankin Scale (mRS).
In 213 patients with AIS [mean age: 76.1 (±12.5) years, 53.1% males, median NIHSS score on admission: 13 (IQR: 9-17)], higher levels of β-synuclein, NfL and GFAP were associated with higher NIHSS scores and with lower Alberta Stroke Program CT Score (ASPECTS) points on admission. Serum β-synuclein levels was significantly correlated with NfL (rho = 0.715, p < 0.001) and GFAP concentrations (rho = 0.684, p < 0.001). The inclusion of serum β-synuclein significantly improved the accuracy of prediction models without biomarkers for overall mortality (AUC: 0.836 vs. 0.752, p < 0.001) and mRS 3-6 vs. 0-2 (AUC: 0.812 vs. 0.624, p < 0.001). Combination models with NfL and/or GFAP showed a similar accuracy.
Serum β-synuclein may be used to assess synaptic damage/dysfunction and to predict 3-months clinical outcomes in patients with AIS.
我们旨在研究β-突触核蛋白与神经丝轻链（NfL）和胶质纤维酸性蛋白（GFAP）相比，在预测急性缺血性卒中（AIS）后功能结局方面的预后作用。
我们对213例连续的中重度AIS患者入院24小时后测定血清β-突触核蛋白、NfL和GFAP浓度。我们研究了血清生物标志物与放射学/临床特征、3个月死亡率以及改良Rankin量表（mRS）功能结局之间的关联。
在213例AIS患者中[平均年龄：76.1（±12.5）岁，男性占53.1%，入院时NIHSS评分中位数：13（四分位间距：9 - 17）]，较高水平的β-突触核蛋白、NfL和GFAP与较高的NIHSS评分以及入院时较低的阿尔伯塔卒中项目CT评分（ASPECTS）相关。血清β-突触核蛋白水平与NfL（rho = 0.715，p < 0.001）和GFAP浓度（rho = 0.684，p < 0.001）显著相关。纳入血清β-突触核蛋白显著提高了无生物标志物预测模型对总体死亡率（AUC：0.836对0.752，p < 0.001）和mRS 3 - 6对0 - 2（AUC：0.812对0.624，p < 0.001）的预测准确性。与NfL和/或GFAP的联合模型显示出相似的准确性。
血清β-突触核蛋白可用于评估AIS患者的突触损伤/功能障碍，并预测3个月的临床结局。
