Diagnostic Potential of the NMDA Receptor Peptide Assay for Acute Ischemic Stroke
AuthorsDambinova, Svetlana A.
Weissman, Joseph D.
Sowell, Richard L.
MetadataShow full item record
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.
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.
CitationPLoS One. 2012 Jul 27; 7(7):e42362
- [The biomarkers of cerebral ischemia as a new method for the validation of the efficacy of cytoprotective therapy].
- Authors: Dambinova SA, Aliev KT, Bondarenko EV, Ponomarev GV, Skoromets AA, Skoromets AP, Skoromets TA, Smolko DG, Shumilina MV
- Issue date: 2017
- Blood Biomarkers for the Early Diagnosis of Stroke: The Stroke-Chip Study.
- Authors: Bustamante A, López-Cancio E, Pich S, Penalba A, Giralt D, García-Berrocoso T, Ferrer-Costa C, Gasull T, Hernández-Pérez M, Millan M, Rubiera M, Cardona P, Cano L, Quesada H, Terceño M, Silva Y, Castellanos M, Garces M, Reverté S, Ustrell X, Marés R, Baiges JJ, Serena J, Rubio F, Salas E, Dávalos A, Montaner J
- Issue date: 2017 Sep
- Clinical usefulness of a biomarker-based diagnostic test for acute stroke: the Biomarker Rapid Assessment in Ischemic Injury (BRAIN) study.
- Authors: Laskowitz DT, Kasner SE, Saver J, Remmel KS, Jauch EC, BRAIN Study Group.
- Issue date: 2009 Jan
- Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke.
- Authors: Higashida RT, Furlan AJ, Roberts H, Tomsick T, Connors B, Barr J, Dillon W, Warach S, Broderick J, Tilley B, Sacks D, Technology Assessment Committee of the American Society of Interventional and Therapeutic Neuroradiology., Technology Assessment Committee of the Society of Interventional Radiology.
- Issue date: 2003 Aug
- A biochemical marker panel in MRI-proven hyperacute ischemic stroke-a prospective study.
- Authors: Knauer C, Knauer K, Müller S, Ludolph AC, Bengel D, Müller HP, Huber R
- Issue date: 2012 Mar 8