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

Journal article
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
Volume 266
Issue 11
Pages 2796-2806
ISSN 0340-5354
Publication year 2019
Published at Department of Mathematical Sciences
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Department of Laboratory Medicine
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Pages 2796-2806
Language en
Keywords Biomarkers, Cerebrovascular disease, Prognosis, Stroke in young adults, wallerian degeneration, cerebrospinal-fluid, biomarker, chain, classification, history, Neurosciences & Neurology
Subject categories Neurology, Neurosciences


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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