title: Serum protein S100β is a diagnostic biomarker for distinguishing posterior circulation stroke from vertigo of nonvascular causes.
abstract: BACKGROUND
  In patients presenting with acute vertigo or dizziness, identifying the posterior fossa stroke as the underlying cause can be a major challenge. We therefore evaluated the serum biomarkers for the differential diagnosis of nonvascular vertigo and posterior circulation stroke.
  
  
  METHODS
  Of a total of 80 patients, 31 patients had an ischemic stroke in the posterior circulation and 12 infratentorial hemorrhage. Findings in these patients were compared with those in 22 patients with vertigo of nonvascular origin and 15 matched control patients without neurological symptoms. Blood samples drawn <24 h after symptom onset were analyzed for S100 calcium-binding protein B (S100β), matrix metalloproteinase 9 (MMP-9), soluble vascular cellular adhesion molecule-1 (sVCAM-1), and glial fibrillary acidic protein (GFAP).
  
  
  CONCLUSIONS
  Serum levels of S100β were significantly higher in stroke patients than in nonvascular vertigo patients. Serum concentrations of MMP-9 tended to be higher in stroke patients, whereas no significant differences among groups were found for sVCAM-1 and GFAP. Receiver-operating characteristic analysis revealed a sensitivity of 94.4% and a specificity of 31.8% for detecting stroke in patients presenting with vertigo for S100β. S100β may serve as a biomarker for distinguishing between vertigo of vascular causes and nonvascular, acute vertigo.
authors.affiliation: Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Jan C
authors.initials: JC
authors.lastname: Purrucker
authors.forename: Oliver
authors.initials: O
authors.lastname: Herrmann
authors.forename: Julia K
authors.initials: JK
authors.lastname: Lutsch
authors.forename: Markus
authors.initials: M
authors.lastname: Zorn
authors.forename: Markus
authors.initials: M
authors.lastname: Schwaninger
authors.forename: Tom
authors.initials: T
authors.lastname: Bruckner
authors.forename: Gerd U
authors.initials: GU
authors.lastname: Auffarth
authors.forename: Roland
authors.initials: R
authors.lastname: Veltkamp
mesh_terms: D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000097:blood; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012372:ROC Curve; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood*; D012680:Sensitivity and Specificity; D020521:Stroke / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014717:Vertigo / Q000097:blood* / Q000175:diagnosis / Q000209:etiology
chemical_list: D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human; D019010:Vascular Cell Adhesion Molecule-1; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9