Prediction of early clinical severity and extent of neuronal damage in anterior-circulation infarction using the initial serum neuron-specific enolase level.
BACKGROUND
Prompt and precise measurement of neuronal damage in acute cerebral infarction is important to determine the prognosis of functional outcome. A feasible biochemical marker such as the neuron-specific enolase (NSE) level has been used to detect various diseases involving the central nervous system.


OBJECTIVE
To determine whether the initial serum NSE level is a useful marker for predicting the severity of clinical neurological deficits and the extent of neuronal damage in acute anterior-circulation infarction.


METHODS
Case-control study with biochemical-clinicoradiological correlation.


METHODS
Tertiary care center.


METHODS
Eighty-one patients and 77 age- and sex-matched control subjects.


METHODS
Patients with anterior-circulation infarction underwent intravenous serum NSE sampling within 24 hours after symptom onset. Recent infarction was confirmed by T2-weighted and diffusion-weighted magnetic resonance imaging of the brain about 1 week after the onset of stroke. Volumetric analysis of infarction was also performed. The National Institutes of Health Stroke Scale score was measured on admission to the hospital and 1 week after symptom onset.


RESULTS
The patients' initial serum NSE levels were statistically significantly higher than the controls (P<.05). The initial serum NSE level highly correlated with the volume of infarction seen on T2-weighted magnetic resonance imaging of the brain (r = 0.62, P<.001) and with the National Institutes of Health Stroke Scale score obtained on hospital admission (r = 0.42, P =.002) and on the seventh day after the onset of stroke (r = 0.44, P<.001).


CONCLUSIONS
The initial serum NSE level is a reliable predictor for the extent of neuronal damage and the severity of clinical neurological deficits in acute anterior-circulation infarction.
Oh
Seung-Hun
SH
Department of Neurology, Yongdong Severance Hospital, Yonsei University College of Medicine, Kangnam-gu, Seoul, South Korea.
Lee
Jin-Goo
JG
Na
Sang-Jun
SJ
Park
Ji-Hyung
JH
Choi
Young-Chul
YC
Kim
Won-Joo
WJ
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000097:blood* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012720:Severity of Illness Index
D015415:Biomarkers; D010751:Phosphopyruvate Hydratase