Avaliação de marcadores neuroquímicos e neuroinflamatórios periféricos em pacientes com acidente vascular cerebral isquêmico (AVCi) leve a moderado

Abstract

Introduction: Acute ischemic stroke (AIS) leads to a sudden reduction in cerebral blood flow, starts an acute neuroinflammation process due to tissue hypoxia, which leads the perpetuation of a chronic process and consequent neuronal damage and death. Cognitive impairment and post-stroke dementia are known sources of morbidity and mortality for affected patients. Therefore, early screening of potential inflammatory biomarkers may contribute to severity stratification and prediction of cognitive outcomes. Methodology: Individuals with minor to moderate AIS (n=21) were recruited and compared with controls (n=21) matched for age, sex and education. Data were collected using the following instruments: National Institutes of Health Stroke Scale (NIHSS), Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and Visual Memory Test of the Brief Cognitive Battery (VMT) up to seven days after the stroke ictus. Peripheral blood plasma samples were collected to measure calcium-binding protein B S100 (S100B), fractalkine (CX3CL1), brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE), amyloid precursor protein (APP), neurofilament light chain (NFL), and ubiquitin carboxy-terminal hydrolase L1 (UCHL-1). For group comparisons, the Mann–Whitney test and Fisher’s exact test or chi-square test were used. Correlation between biomarkers and clinical parameters was assessed through simple linear regression. Results: The groups were similar with MMSE scores. The stroke group showed lower FAB scores (p = 0.002). On the VMT, AIS patients demonstrated decrease in immediate memory (p = 0.001), learning (p = 0.045), recall (p = 0.030), and recognition (p = 0.037). Individuals with AIS had increased UCHL-1 (p = 0.048) and NSE (p = 0.005) levels, and reduced S100B (p = 0.047). CX3CL1, BDNF, APP, and NFL concentrations were similar between groups. CX3CL1 and NSE concentrations were associated with worse FAB performance; NSE and APP concentrations correlated with impairments in recall, recognition, and learning on the VMT. S100B and NSE levels were associated with NIHSS scores. Conclusion: The results suggest NSE, and S100B has potential as plasma biomarkers of cognitive decline and AIS severity.