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Open Access 01-11-2019 | Stroke | Original Communication

Circulating neurofilament light in ischemic stroke: temporal profile and outcome prediction

Authors: Annie Pedersen, Tara M. Stanne, Staffan Nilsson, Sofia Klasson, Lars Rosengren, Lukas Holmegaard, Katarina Jood, Kaj Blennow, Henrik Zetterberg, Christina Jern

Published in: Journal of Neurology | Issue 11/2019

Abstract

Background and purpose

Neurofilament light chain (NfL) is a marker of neuroaxonal damage. We aimed to study associations between serum NfL (sNfL) concentrations at different time points after ischemic stroke and outcomes.

Methods

We prospectively included ischemic stroke cases (n = 595, mean age 59 years, 64% males) and assessed outcomes by both the modified Rankin Scale (mRS) and the NIH stroke scale (NIHSS) at 3 months and by mRS at 2 years. In a subsample, long-term (7-year) outcomes were also assessed by both mRS and NIHSS. We used the ultrasensitive single-molecule array assay to measure sNfL in the acute phase (range 1–14, median 4 days), after 3 months and 7 years in cases and once in controls (n = 595).

Results

Acute-phase sNfL increased by the time to blood-draw and highest concentrations were observed at 3 months post-stroke. High sNfL associated to stroke severity and poor outcomes, and both associations were strongest for 3-month sNfL. After adjusting for age, previous stroke, stroke severity, and day of blood draw, 3-month sNfL was significantly associated to both outcomes at all time points (p < 0.01 throughout). For all main etiological subtypes, both acute phase and 3-month sNfL were significantly higher than in controls, but the dynamics of sNfL differed by stroke subtype.

Conclusions

The results from this study inform on sNfL in ischemic stroke and subtypes over time, and show that sNfL predicts short- and long-term neurological and functional outcomes. Our findings suggest a potential utility of sNfL in ischemic stroke outcome prediction.

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Title: Circulating neurofilament light in ischemic stroke: temporal profile and outcome prediction
Authors: Annie Pedersen
Tara M. Stanne
Staffan Nilsson
Sofia Klasson
Lars Rosengren
Lukas Holmegaard
Katarina Jood
Kaj Blennow
Henrik Zetterberg
Christina Jern
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keyword: Stroke
Published in: Journal of Neurology / Issue 11/2019
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-019-09477-9

At a glance: The STEP trials

Springer Medicine

Circulating neurofilament light in ischemic stroke: temporal profile and outcome prediction

Abstract

Background and purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background and purpose

Methods

Results

Conclusions

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