Zhiqiang Wang1,2, Rongyu Wang1,2, Yuxia Li3, Mao Li1,2, Yaodan Zhang1,2, Lianyan Jiang1,2, Jin Fan2, Qingsong Wang3, Dongdong Yang1. 1. Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China. 2. School of Clinical Medicine, Chengdu University of TCM, Chengdu, China. 3. Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China.
Abstract
BACKGROUND: Plasma neurofilaments light chain (pNfL) is a marker of axonal injury. The purpose of this study was to examine the role of pNfL as a predictive biomarker for post-stroke cognitive impairment (PSCI). METHODS: A prospective single-center observational cohort study was conducted at the General Hospital of Western Theater Command between July 1, 2017 and December 31, 2019. Consecutive patients ≥18 years with first-ever acute ischemic stroke (AIS) of anterior circulation within 24 h of symptom onset were included. PSCI was defined by the Montreal Cognitive Assessment (MOCA) (MOCA < 26) at 90 days after stroke onset. RESULTS: A total of 1,694 patients [male, 893 (52.70%); median age, 64 (16) years] were enrolled in the cohort analysis, and 1,029 (60.70%) were diagnosed with PSCI. Patients with PSCI had significantly higher pNfL [median (IQR), 55.96 (36.13) vs. 35.73 (17.57) pg/ml; P < 0.001] than Non-PSCI. pNfL was valuable for the prediction of PSCI (OR 1.044, 95% CI 1.038-1.049, P < 0.001) after a logistic regression analysis, even after adjusting for conventional risk factors including age, sex, education level, NIHSS, TOAST classification, and infarction volume (OR 1.041, 95% CI 1.034-1.047, P < 0.001). The optimal cutoff value of the pNfL concentration was 46.12 pg/ml, which yielded a sensitivity of 71.0% and a specificity of 81.5%, with the area under the curve (AUC) at 0.785 (95% CI 0.762-0.808, P < 0.001). CONCLUSION: This prospective cohort study showed that the pNfL concentration within 48 h of onset was an independent risk factor for PSCI 90 days after an anterior circulation stroke, even after being adjusted for potential influencing factors regarded as clinically relevant. CLINICAL TRIAL REGISTRATION: www.chictr.org.cn, identifier ChiCTR1800020330.
BACKGROUND: Plasma neurofilaments light chain (pNfL) is a marker of axonal injury. The purpose of this study was to examine the role of pNfL as a predictive biomarker for post-stroke cognitive impairment (PSCI). METHODS: A prospective single-center observational cohort study was conducted at the General Hospital of Western Theater Command between July 1, 2017 and December 31, 2019. Consecutive patients ≥18 years with first-ever acute ischemic stroke (AIS) of anterior circulation within 24 h of symptom onset were included. PSCI was defined by the Montreal Cognitive Assessment (MOCA) (MOCA < 26) at 90 days after stroke onset. RESULTS: A total of 1,694 patients [male, 893 (52.70%); median age, 64 (16) years] were enrolled in the cohort analysis, and 1,029 (60.70%) were diagnosed with PSCI. Patients with PSCI had significantly higher pNfL [median (IQR), 55.96 (36.13) vs. 35.73 (17.57) pg/ml; P < 0.001] than Non-PSCI. pNfL was valuable for the prediction of PSCI (OR 1.044, 95% CI 1.038-1.049, P < 0.001) after a logistic regression analysis, even after adjusting for conventional risk factors including age, sex, education level, NIHSS, TOAST classification, and infarction volume (OR 1.041, 95% CI 1.034-1.047, P < 0.001). The optimal cutoff value of the pNfL concentration was 46.12 pg/ml, which yielded a sensitivity of 71.0% and a specificity of 81.5%, with the area under the curve (AUC) at 0.785 (95% CI 0.762-0.808, P < 0.001). CONCLUSION: This prospective cohort study showed that the pNfL concentration within 48 h of onset was an independent risk factor for PSCI 90 days after an anterior circulation stroke, even after being adjusted for potential influencing factors regarded as clinically relevant. CLINICAL TRIAL REGISTRATION: www.chictr.org.cn, identifier ChiCTR1800020330.
Authors: Bob Olsson; Erik Portelius; Nicholas C Cullen; Åsa Sandelius; Henrik Zetterberg; Ulf Andreasson; Kina Höglund; David J Irwin; Murray Grossman; Daniel Weintraub; Alice Chen-Plotkin; David Wolk; Leo McCluskey; Lauren Elman; Leslie M Shaw; Jon B Toledo; Jennifer McBride; Pilar Hernandez-Con; Virginia M-Y Lee; John Q Trojanowski; Kaj Blennow Journal: JAMA Neurol Date: 2019-03-01 Impact factor: 18.302
Authors: Yakeel T Quiroz; Henrik Zetterberg; Eric M Reiman; Yinghua Chen; Yi Su; Joshua T Fox-Fuller; Gloria Garcia; Andres Villegas; Diego Sepulveda-Falla; Marina Villada; Joseph F Arboleda-Velasquez; Edmarie Guzmán-Vélez; Clara Vila-Castelar; Brian A Gordon; Stephanie A Schultz; Hillary D Protas; Valentina Ghisays; Margarita Giraldo; Victoria Tirado; Ana Baena; Claudia Munoz; Silvia Rios-Romenets; Pierre N Tariot; Kaj Blennow; Francisco Lopera Journal: Lancet Neurol Date: 2020-05-26 Impact factor: 44.182
Authors: Mehtap Bacioglu; Luis F Maia; Oliver Preische; Juliane Schelle; Anja Apel; Stephan A Kaeser; Manuel Schweighauser; Timo Eninger; Marius Lambert; Andrea Pilotto; Derya R Shimshek; Ulf Neumann; Philipp J Kahle; Matthias Staufenbiel; Manuela Neumann; Walter Maetzler; Jens Kuhle; Mathias Jucker Journal: Neuron Date: 2016-06-09 Impact factor: 17.173
Authors: Henrik Zetterberg; Tobias Skillbäck; Niklas Mattsson; John Q Trojanowski; Erik Portelius; Leslie M Shaw; Michael W Weiner; Kaj Blennow Journal: JAMA Neurol Date: 2016-01 Impact factor: 18.302
Authors: Rosalind Lees; Johann Selvarajah; Candida Fenton; Sarah T Pendlebury; Peter Langhorne; David J Stott; Terence J Quinn Journal: Stroke Date: 2014-09-04 Impact factor: 7.914
Authors: Claire Bridel; Wessel N van Wieringen; Henrik Zetterberg; Betty M Tijms; Charlotte E Teunissen; José C Alvarez-Cermeño; Ulf Andreasson; Markus Axelsson; David C Bäckström; Ales Bartos; Maria Bjerke; Kaj Blennow; Adam Boxer; Lou Brundin; Joachim Burman; Tove Christensen; Lenká Fialová; Lars Forsgren; Jette L Frederiksen; Magnus Gisslén; Elizabeth Gray; Martin Gunnarsson; Sara Hall; Oskar Hansson; Megan K Herbert; Joel Jakobsson; Jan Jessen-Krut; Shorena Janelidze; Gudmundur Johannsson; Michael Jonsson; Ludwig Kappos; Mohsen Khademi; Michael Khalil; Jens Kuhle; Mikael Landén; Ville Leinonen; Giancarlo Logroscino; Ching-Hua Lu; Jan Lycke; Nadia K Magdalinou; Andrea Malaspina; Niklas Mattsson; Lieke H Meeter; Sanjay R Mehta; Signe Modvig; Tomas Olsson; Ross W Paterson; Josué Pérez-Santiago; Fredrik Piehl; Yolande A L Pijnenburg; Okko T Pyykkö; Oskar Ragnarsson; Julio C Rojas; Jeppe Romme Christensen; Linda Sandberg; Carole S Scherling; Jonathan M Schott; Finn T Sellebjerg; Isabella L Simone; Tobias Skillbäck; Morten Stilund; Peter Sundström; Anders Svenningsson; Rosanna Tortelli; Carla Tortorella; Alessandro Trentini; Maria Troiano; Martin R Turner; John C van Swieten; Mattias Vågberg; Marcel M Verbeek; Luisa M Villar; Pieter Jelle Visser; Anders Wallin; Andreas Weiss; Carsten Wikkelsø; Edward J Wild Journal: JAMA Neurol Date: 2019-09-01 Impact factor: 18.302