Serum Neurofilament Light Chain in Patients with Acute Cerebrovascular Events.

De Marchis, Gian Marco; Katan, Mira; Barro, Christian; Fladt, Joachim; Traenka, Christopher; Seiffge, David J; Hert, Lisa; Gensicke, Henrik; Disanto, Giulio; Sutter, Raoul; Peters, Nils; Sarikaya, Hakan; Goeggel Simonetti, Barbara; El-Koussy, Marwan; Engelter, Stephan; Lyrer, Philippe A; Christ-Crain, Mirjam; Arnold, Marcel; Kuhle, Jens and Bonati, Leo (2018). Serum Neurofilament Light Chain in Patients with Acute Cerebrovascular Events. European journal of neurology, 25(3), pp. 562-568. Wiley-Blackwell 10.1111/ene.13554

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BACKGROUND AND PURPOSE

Serum Neurofilaments are markers of axonal injury. We addressed their diagnostic and prognostic role in acute ischemic stroke (AIS) and TIA.

METHODS

Nested within a prospective cohort study, we compared serum neurofilament light chain levels (sNfL) drawn within 24 hours from symptom onset in patients with AIS or TIA. Patients without MRI on admission were excluded. We assessed if sNfL are associated with: (i) clinical severity on admission, (ii) diagnosis of AIS vs TIA, (iii) infarct size on admission diffusion weighted imaging (MR-DWI), and (iv) functional outcome at 3 months.

RESULTS

We analyzed 504 patients with AIS and 111 patients with TIA. On admission, higher NIHSS scores were associated with higher sNfL: NIHSS<7 (13.1 pg/ml [IQR: 5.3-27.8]), NIHSS 7-15 (IQR: 16.7 pg/ml [7.4-34.9]), NIHSS>15 (21.0 pg/ml [IQR: 9.3-40.4]) (P=0.01). Compared to AIS, patients with TIA had lower sNfL levels (9.0 pg/ml [95%-CI 4.0-19.0] vs. 16.0 pg/ml [95%-CI 7.3-34.4], P<0.001), also after adjusting for age and NIHSS (P=0.006). Among patients with AIS, infarct size on admission MR-DWI was not associated with sNfL, neither in univariate analysis (P=0.15), nor after adjusting for age and NIHSS on admission (P=0.56). Functional outcome three months after stroke was not associated with sNfL after adjusting for established predictors.

CONCLUSIONS

In conclusion, among patients admitted within 24 hours of AIS or TIA onset, admission sNfL were associated with clinical severity on admission and TIA diagnosis, but not with infarct size on MR-DWI acquired on admission or functional outcome at three months. This article is protected by copyright. All rights reserved.

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