Serum Protein S100β is a Diagnostic Biomarker for Distinguishing Posterior Circulation Stroke from Vertigo of Nonvascular Causes

Abstract

Background: In patients presenting with acute vertigo or dizziness, identifying the posterior fossa stroke as the underlying cause can be a major challenge. We therefore evaluated the serum biomarkers for the differential diagnosis of nonvascular vertigo and posterior circulation stroke. Methods: Of a total of 80 patients, 31 patients had an ischemic stroke in the posterior circulation and 12 infratentorial hemorrhage. Findings in these patients were compared with those in 22 patients with vertigo of nonvascular origin and 15 matched control patients without neurological symptoms. Blood samples drawn <24 h after symptom onset were analyzed for S100 calcium-binding protein B (S100β), matrix metalloproteinase 9 (MMP-9), soluble vascular cellular adhesion molecule-1 (sVCAM-1), and glial fibrillary acidic protein (GFAP). Results/Conclusion: Serum levels of S100β were significantly higher in stroke patients than in nonvascular vertigo patients. Serum concentrations of MMP-9 tended to be higher in stroke patients, whereas no significant differences among groups were found for sVCAM-1 and GFAP. Receiver-operating characteristic analysis revealed a sensitivity of 94.4% and a specificity of 31.8% for detecting stroke in patients presenting with vertigo for S100β. S100β may serve as a biomarker for distinguishing between vertigo of vascular causes and nonvascular, acute vertigo.

Prediction of Outcome in Diabetic Acute Ischemic Stroke Patients: A Hospital-Based Pilot Study Report

“…Some of them such as neuron-specific enolase (NSE), S100ββ protein, glial fibrillary acidic protein, myelin basic protein, creatine kinase isoenzyme BB, tau protein, matrix metalloproteinase-9 were found to be very promising in predicting outcomes in AIS patients [10,11] . In an earlier study, we reported that the serum level of Inter-alpha-trypsin inhibitor heavy chain 4 (ITIH4) protein (120-kDa) could be a useful biomarker for prognosis of AIS patients [12,13] .…”

Perfusion by delayed time to peak in vertebrobasilar dolichoectasia patients with vertigo

“…A meta‐analysis demonstrated that 6.8% patients with acute ischemic stroke had a negative DWI scan and patients with posterior circulation ischemia had five times the odds of having a negative DWI 21. It has previously been shown that the glial‐specific S100 calcium‐binding protein β (S100 β ) provides a useful serum marker of stroke 22, 23. That seems to be a good candidate to detect stroke for patients with negative DWI imaging.…”

“…21 It has previously been shown that the glial-specific S100 calcium-binding protein b (S100b) provides a useful serum marker of stroke. 22,23 That seems to be a good candidate to detect stroke for patients with negative DWI imaging. However, Purrucker et al 22 focused on patients presenting with acute vertigo and found that S100b had a high sensitivity of 94.4% for detecting stroke in patients with vertigo but the specificity was low (31.8%).…”

“…22,23 That seems to be a good candidate to detect stroke for patients with negative DWI imaging. However, Purrucker et al 22 focused on patients presenting with acute vertigo and found that S100b had a high sensitivity of 94.4% for detecting stroke in patients with vertigo but the specificity was low (31.8%). The Youden index was 0.262 which was not only lower than that of TTP in the right temporal lobe but in other ROIs in our study, demonstrating that delayed TTP might be a better predictive factor for detecting posterior circulation ischemic stroke, especially in VBD patients.…”

Ischemic Stroke

“…Two observational prospective studies found statistically signifi cant higher levels of S100B in patients with posterior circulation stroke than in patients with noncentral causes of vertigo [ 9 , 10 ]. Receiver-operating characteristic analysis revealed a sensitivity of 94.4 % and a specifi city of 31.8 % for detecting stroke in patients presenting with vertigo for S100B [ 9 ].…”