Diagnostic Potential of the NMDA Receptor Peptide Assay for Acute Ischemic Stroke

Hdl Handle:
http://hdl.handle.net/10675.2/816
Title:
Diagnostic Potential of the NMDA Receptor Peptide Assay for Acute Ischemic Stroke
Authors:
Dambinova, Svetlana A.; Bettermann, Kerstin; Glynn, Theodore; Tews, Matthew; Olson, David; Weissman, Joseph D.; Sowell, Richard L.
Abstract:
Background: The acute assessment of patients with suspected ischemic stroke remains challenging. The use of brain biomarker assays may improve the early diagnosis of ischemic stroke. The main goal of the study was to evaluate whether the NR2 peptide, a product of the proteolytic degradation of N-methyl-D-aspartate (NMDA) receptors, can differentiate acute ischemic stroke (IS) from stroke mimics and persons with vascular risk factors/healthy controls. A possible correlation between biomarker values and lesion sizes was investigated as the secondary objective.; Methods and Findings: A total of 192 patients with suspected stroke who presented within 72 h of symptom onset were prospectively enrolled. The final diagnosis was determined based on clinical observations and radiological findings. Additionally gender- and age-matched healthy controls (n = 52) and persons with controlled vascular risk factors (n = 48) were recruited to compare NR2 peptide levels. Blinded plasma was assayed by rapid magnetic particles (MP) ELISA for NR2 peptide within 30 min and results for different groups compared using univariate and multivariate statistical analyses. There was a clinical diagnosis of IS in 101 of 192 (53%) and non-stroke in 91 (47%) subjects. The non-stroke group included presented with acute stroke symptoms who had no stroke (n = 71) and stroke mimics (n = 20). The highest NR2 peptide elevations where found in patients with IS that peaked at 12 h following symptom onset. When the biomarker cut off was set at 1.0 ug/L, this resulted in a sensitivity of 92% and a specificity of 96% to detect IS. A moderate correlation (rs = 0.73) between NR2 peptide values and acute ischemic cortical lesions (<200 mL) was found.; Conclusions: This study suggests that the NR2 peptide may be a brain specific biomarker to diagnose acute IS and may allow the differentiation of IS from stroke mimics and controls. Additional larger scale clinical validation studies are required.
Citation:
PLoS One. 2012 Jul 27; 7(7):e42362
Issue Date:
27-Jul-2012
URI:
http://hdl.handle.net/10675.2/816
DOI:
10.1371/journal.pone.0042362
PubMed ID:
22848761
PubMed Central ID:
PMC3407099
Type:
Article
ISSN:
1932-6203
Appears in Collections:
Department of Neurology: Faculty Research and Presentations

Full metadata record

DC FieldValue Language
dc.contributor.authorDambinova, Svetlana A.en_US
dc.contributor.authorBettermann, Kerstinen_US
dc.contributor.authorGlynn, Theodoreen_US
dc.contributor.authorTews, Matthewen_US
dc.contributor.authorOlson, Daviden_US
dc.contributor.authorWeissman, Joseph D.en_US
dc.contributor.authorSowell, Richard L.en_US
dc.date.accessioned2012-10-26T20:35:09Z-
dc.date.available2012-10-26T20:35:09Z-
dc.date.issued2012-07-27en_US
dc.identifier.citationPLoS One. 2012 Jul 27; 7(7):e42362en_US
dc.identifier.issn1932-6203en_US
dc.identifier.pmid22848761en_US
dc.identifier.doi10.1371/journal.pone.0042362en_US
dc.identifier.urihttp://hdl.handle.net/10675.2/816-
dc.description.abstractBackground: The acute assessment of patients with suspected ischemic stroke remains challenging. The use of brain biomarker assays may improve the early diagnosis of ischemic stroke. The main goal of the study was to evaluate whether the NR2 peptide, a product of the proteolytic degradation of N-methyl-D-aspartate (NMDA) receptors, can differentiate acute ischemic stroke (IS) from stroke mimics and persons with vascular risk factors/healthy controls. A possible correlation between biomarker values and lesion sizes was investigated as the secondary objective.en_US
dc.description.abstractMethods and Findings: A total of 192 patients with suspected stroke who presented within 72 h of symptom onset were prospectively enrolled. The final diagnosis was determined based on clinical observations and radiological findings. Additionally gender- and age-matched healthy controls (n = 52) and persons with controlled vascular risk factors (n = 48) were recruited to compare NR2 peptide levels. Blinded plasma was assayed by rapid magnetic particles (MP) ELISA for NR2 peptide within 30 min and results for different groups compared using univariate and multivariate statistical analyses. There was a clinical diagnosis of IS in 101 of 192 (53%) and non-stroke in 91 (47%) subjects. The non-stroke group included presented with acute stroke symptoms who had no stroke (n = 71) and stroke mimics (n = 20). The highest NR2 peptide elevations where found in patients with IS that peaked at 12 h following symptom onset. When the biomarker cut off was set at 1.0 ug/L, this resulted in a sensitivity of 92% and a specificity of 96% to detect IS. A moderate correlation (rs = 0.73) between NR2 peptide values and acute ischemic cortical lesions (<200 mL) was found.en_US
dc.description.abstractConclusions: This study suggests that the NR2 peptide may be a brain specific biomarker to diagnose acute IS and may allow the differentiation of IS from stroke mimics and controls. Additional larger scale clinical validation studies are required.en_US
dc.subjectResearch Articleen_US
dc.subjectMedicineen_US
dc.subjectClinical Research Designen_US
dc.subjectCohort Studiesen_US
dc.subjectCritical Care and Emergency Medicineen_US
dc.subjectNeurointensive Careen_US
dc.subjectDiagnostic Medicineen_US
dc.subjectPathologyen_US
dc.subjectClinical Pathologyen_US
dc.subjectClinical Chemistryen_US
dc.subjectGeneral Pathologyen_US
dc.subjectBiomarkersen_US
dc.subjectDrugs and Devicesen_US
dc.subjectMedical Devicesen_US
dc.subjectNeurologyen_US
dc.subjectCerebrovascular Diseasesen_US
dc.subjectIschemic Strokeen_US
dc.subjectNursing Scienceen_US
dc.subjectNursing Educationen_US
dc.titleDiagnostic Potential of the NMDA Receptor Peptide Assay for Acute Ischemic Strokeen_US
dc.typeArticleen_US
dc.identifier.pmcidPMC3407099en_US
dc.contributor.corporatenameDepartment of Neurology-

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