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Plasma neurofilament light chain levels predict improvement in late phase after stroke
Author(s) -
Stokowska Anna,
Bunketorp Käll Lina,
Blomstrand Christian,
Simrén Joel,
Nilsson Michael,
Zetterberg Henrik,
Blennow Kaj,
Pekny Milos,
Pekna Marcela
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14854
Subject(s) - medicine , stroke (engine) , balance (ability) , biomarker , odds ratio , confidence interval , gait , physical medicine and rehabilitation , rehabilitation , physical therapy , mechanical engineering , biochemistry , chemistry , engineering
Background and purpose Although functional recovery is most pronounced in the first 6 months after stroke, improvement is possible also in the late phase. The value of plasma neurofilament light chain (NfL), a biomarker of axonal injury and secondary neurodegeneration, was explored for the prediction of functional improvement in the late phase after stroke. Methods Baseline plasma NfL levels were measured in 115 participants of a trial on the efficacy of multimodal rehabilitation in the late phase after stroke. The association between NfL levels, impairment in balance, gait and cognitive domains, and improvement 3 and 9 months later was determined. Results Plasma NfL levels were associated with the degree of impairment in all three domains. Individuals with meaningful improvement in balance and gait capacity had higher plasma NfL levels compared with non‐improvers ( p = 0.001 and p = 0.018, respectively). Higher NfL levels were associated with improvement in balance (odds ratio [OR] 2.34, 95% confidence interval [CI] 1.35–4.27, p = 0.004) and gait (OR 2.27, 95% CI 1.25–4.32, p = 0.009). Elevated plasma NfL levels showed a positive predictive value for cognitive improvement, and this effect was specific for the intervention targeting the cognitive domain. The association of NfL levels with cognitive improvement withstood correction for baseline impairment, age and total years of schooling (OR 7.54, 95% CI 1.52–45.66, p = 0.018). Conclusions In addition to its established role as a biomarker in the acute phase, elevated circulating NfL levels may predict functional improvement in the late phase after stroke. Our results should prompt further studies into the use of plasma NfL as a biomarker in the late phase after stroke.