Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Feb 06, 2020)
Date Submitted: Jan 15, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Prognostic significance of serum neurofilament light chain in acute ischemic stroke: a retrospective cohort study
ABSTRACT
Background:
Acute ischemic stroke affects a large number of people each year around the world. However, accurately predicting clinical outcome is still difficult.
Objective:
The aim of this cohort study was to explore the relationship between serum neurofilament light (NfL) concentration and clinical outcomes in these patients.
Methods:
A total of 820 patients with acute ischemic stroke were retrospectively enrolled between January 2012 and June 2017. Changes in patients' conditions, imaging data and other necessary information were obtained from their medical records. Blood samples were collected several times during the first two weeks of admission. Serum NfL levels were measured using a commercial Simoa NfL assay. In 6-month follow-up period, daily activity and cognitive function were assessed using modified Rankin Scale and Mini-mental State Examination.
Results:
Serum NfL levels gradually increased after the disease onset and peaked on the 7th day of admission. The elevated levels of peak NfL were roughly associated with the increased risk of poor daily activity function (OR: 2.92, 95%CI: 1.66 - 5.13), poor cognitive function (OR: 1.54, 95%CI: 1.03 - 2.29; OR: 1.66, 95%CI: 1.11 - 2.47; OR: 1.55, 95%CI: 1.03 - 2.37) and greater cognitive decline during the follow-up period (OR: 2.38, 95%CI: 1.07 - 5.26; OR: 1.99, 95%CI: 1.01 - 3.97). However, baseline serum NfL levels did not have similar prognostic significance.
Conclusions:
Elevated peak concentration of NfL in serum predicts poor daily activity performance and cognitive function decline, and might be a prognostic biomarker for acute ischemic stroke. Clinical Trial: None.
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