Correlation between serum neuron specific enolase and functional neurological outcome in patients of acute ischemic stroke

Abstract

Context:The use of biomarkers to predict stroke prognosis is gaining particular attention nowadays. Neuron specific enolase (NSE), which is a dimeric isoenzyme of the glycolytic enzyme enolase and is found mainly in the neurons is one such biomarker.Aims:This study was carried out on patients of acute ischemic stroke with the aims to determine the correlation between NSE levels on the day of admission with infarct volume, stroke severity, and functional neurological outcome on day 30.Materials and Methods:Seventy five patients of acute ischemic stroke admitted in the Department of Medicine were included in the study. Levels of NSE were determined on day 1 using the human NSE ELISA kit (Alpha Diagnostic International Texas 78244, USA). Volume of infarct was measured by computed tomography (CT) scan using the preinstalled software Syngo (version A40A) of Siemen's medical solutions (Forchheim, Germany). Stroke severity at admission was assessed using Glasgow coma scale (GCS) and functional neurological outcome was assessed using modified Rankin scale (mRS) on day 30.Statistical Analysis Used:Statistical analysis was performed using the SPSS software for windows version 15.0 (SPSS).Results:A positive correlation was found between concentration of NSE on day 1 and infarct volume determined by CT scan (r = 0.955, P < 0.001). A strong negative correlation was found between GCS at presentation and concentration of NSE on day 1 (r = −0.806, P < 0.001). There was a positive correlation between NSE levels at day 1 and functional neurological outcome assessed by mRS at day 30 (r = 0.744, P < 0.001).Conclusions:Serum levels of NSE in first few days of ischemic stroke can serve as a useful marker to predict stroke severity and early functional outcome. However, larger studies with serial estimation of NSE are needed to establish these observations more firmly.

Incidence and Clinical Outcome of Patients with Hypertensive Acute Ischemic Stroke: An Update from Tertiary Care Center of Central India

“…NSE is a dimeric isoenzyme of the glycolytic pathway of neuronal cells in brain (Brea et al, 2009). Serum NSE level has been reported to be a useful biomarker for early prediction of severity and outcome in patients with AIS (Zaheer et al, 2013). Similarly, S100ββ is a Ca 2± binding protein found in glial cells in the central nervous system.…”

Update on Inflammatory Biomarkers and Treatments in Ischemic Stroke

“…Furthermore, specific challenges regarding biomarkers of central nervous tissue include the penetration of BBB and the lack of correlation between functional symptoms and volume (as opposed to location) of injured tissue. According to pathophysiological processes underlying IS, potential inflammatory biomarkers may be classified as released by: (i) astroglial activation and neuronal injury (Table 1) [146,147,148,149,150,151,152,153,154,155,156,157]; (ii) systemic inflammatory response (Table 2) [158,159,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175,176,177,178,179]; (iii) dysfunctional endothelium (Table 3) [180,181,182,183,184,185,186] (Figure 4). …”

“…However, the diagnostic accuracy of NSE and H-FEBP is affected by a low sensitivity and their use is not recommended in clinical practice. NSE also correlated with stroke severity at admission [151,152,154] and HT [155], whereas data on long-term outcomes are controversial [153,156]. …”

Serum neuron specific enolase is increased in pediatric acute encephalitis syndrome

“…Comparing of the result with non infectious disease outcome, serum levels of NSE in first few days of ischemic stroke can serve as a useful marker to predict stroke severity and early functional outcome20). Study by Rech et al21) demonstrates that NSE levels measured early in the course of ischemic cerebral injury are significantly higher in patients with unfavorable outcome than in patients with favorable outcome.…”