Journal
CELLS
Volume 10, Issue 6, Pages -Publisher
MDPI
DOI: 10.3390/cells10061537
Keywords
neurofilament light chain; intermediate filament proteins; nanofilament proteins; biomarkers; stroke; cerebrovascular disease; acute phase after stroke; late phase after stroke; stroke recovery; stroke rehabilitation; synaptic plasticity; secondary neurodegeneration
Categories
Funding
- Swedish Research Council [2017-02255, 2017-00991]
- Swedish government [ALFGBG 724421, 716591]
- county councils, the ALF agreement [ALFGBG 724421, 716591]
- AFA Research Foundation
- T. Soderberg's Foundations
- Hagstromer's Foundation Millennium
- Ulla Amlov's Foundation for Neurological and Rheumatological Research
- Swedish Brain Foundation [PS2016-0035, FO2017-0243, FO2020-0134, FO2019-0227]
- Swedish Society for Medical Research [P16-0091]
- P. Eriksson's Foundation
- Edith Jacobson's Foundation
- EuroCellNet COST Action [CA15214]
- Swedish Research Council [2017-00991] Funding Source: Swedish Research Council
- Vinnova [2017-00991] Funding Source: Vinnova
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Research on monitoring blood NfL levels in stroke patients has shown that elevated levels are associated with poor clinical outcomes and can predict future functional improvement, but caution is needed in interpretation. NfL levels at different stages reflect various neurobiological processes.
Increased sensitivity of methods assessing the levels of neurofilament light chain (NfL), a neuron-specific intermediate filament protein, in human plasma or serum, has in recent years led to a number of studies addressing the utility of monitoring NfL in the blood of stroke patients. In this review, we discuss that elevated blood NfL levels after stroke may reflect several different neurobiological processes. In the acute and post-acute phase after stroke, high blood levels of NfL are associated with poor clinical outcome, and later on, the blood levels of NfL positively correlate with secondary neurodegeneration as assessed by MRI. Interestingly, increased blood levels of NfL in individuals who survived stroke for more than 10 months were shown to predict functional improvement in the late phase after stroke. Whereas in the acute phase after stroke the injured axons are assumed to be the main source of blood NfL, synaptic turnover and secondary neurodegeneration could be major contributors to blood NfL levels in the late phase after stroke. Elevated blood NfL levels after stroke should therefore be interpreted with caution. More studies addressing the clinical utility of blood NfL assessment in stroke patients are needed before the inclusion of NfL in the clinical workout as a useful biomarker in both the acute and the chronic phase after stroke.
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