(Stroke. 1999;30:1190-1195.)
© 1999 American Heart Association, Inc.
Original Contributions |
Early Neurobehavioral Outcome After Stroke Is Related to Release of Neurobiochemical Markers of Brain Damage
From the Division of Neuropsychology and Behavioral Neurology (M.T.W., A.D.E., T.K., M.H.) and Department of Neurology (M.G., S.J.), Otto-von-Guericke University, Magdeburg, Germany.
Correspondence to Manfred Herrmann, MD, PhD, Division of Neuropsychology and Behavioral Neurology, Otto-von-Guericke University, Leipziger Str 44, D-39120 Magdeburg, Germany. E-mail manfred.herrmann{at}medizin.uni-magdeburg.de
Background and Purpose—–The study aimed to investigate the predictive value of neurobiochemical markers of brain damage (protein S-100B and neuron-specific enolase [NSE]) with respect to early neurobehavioral outcome after stroke.
Methods—–We investigated 58 patients with completed stroke who were admitted to the stroke unit of the Department of Neurology at Magdeburg University. Serial venous blood samples were taken after admission and during the first 4 days, and protein S-100B and NSE were analyzed by the use of immunoluminometric assays. In all patients, lesion topography and vascular supply were analyzed and volume of infarcted brain areas was calculated. The neurological status was evaluated by a standardized neurological examination and the National Institutes of Health Stroke Scale (NIHSS) on admission, at days 1 and 4 on the stroke unit, at day 10, and at discharge from the hospital. Comprehensive neuropsychological examinations were performed in all patients with first-ever stroke event and supratentorial brain infarctions. Functional outcome was measured with the Barthel score at discharge from the hospital.
Results—–NSE and protein S-100B concentrations were significantly correlated with both volume of infarcted brain areas and NIHSS scores. Patients with an adverse neurological outcome had a significantly higher and significantly longer release of both markers. Neuropsychological impairment was associated with higher protein S-100B release, but this did not reach statistical significance.
Conclusions—–Serum concentrations and kinetics of protein S-100B and NSE have a high predictive value for early neurobehavioral outcome after acute stroke. Protein S-100B concentrations at days 2 to 4 after acute stroke may provide valuable information for both neurological status and functional impairment at discharge from the acute care hospital.
Key Words: health status • nerve tissue • neuron-specific enolase • neuropsychology • outcome • protein S-100 • stroke
This article has been cited by other articles:
 |
|
 |
|
  J. M. Gee, A. Kalil, M. Thullbery, and K. J. Becker Induction of Immunologic Tolerance to Myelin Basic Protein Prevents Central Nervous System Autoimmunity and Improves Outcome After Stroke Stroke, May 1, 2008; 39(5): 1575 - 1582. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. C. Jauch, C. Lindsell, J. Broderick, S. C. Fagan, B. C. Tilley, S. R. Levine, and for the NINDS rt-PA Stroke Study Group Association of Serial Biochemical Markers With Acute Ischemic Stroke: The National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study Stroke, October 1, 2006; 37(10): 2508 - 2513. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Larsson, M. Lipcsey, J. Sjolin, L.-O. Hansson, and M. B. Eriksson Slight Increase of Serum S-100B During Porcine Endotoxemic Shock May Indicate Blood-Brain Barrier Damage Anesth. Analg., November 1, 2005; 101(5): 1465 - 1469. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Foerch, O. C. Singer, T. Neumann-Haefelin, R. du Mesnil de Rochemont, H. Steinmetz, and M. Sitzer Evaluation of Serum S100B as a Surrogate Marker for Long-term Outcome and Infarct Volume in Acute Middle Cerebral Artery Infarction Arch Neurol, July 1, 2005; 62(7): 1130 - 1134. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Iohom, S. Szarvas, V. Larney, J. O'Brien, E. Buckley, M. Butler, and G. Shorten Perioperative Plasma Concentrations of Stable Nitric Oxide Products Are Predictive of Cognitive Dysfunction After Laparoscopic Cholecystectomy Anesth. Analg., October 1, 2004; 99(4): 1245 - 1252. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Avasarala, J. N. Lycke, C. Malmestrom, S. Haghighi, L. Rosengren, and O. Andersen Neurofilament light protein and glial fibrillary acidic protein as biological markers in MS Neurology, August 10, 2004; 63(3): 599 - 599. [Full Text] [PDF]
|
|
|
|
|
|
E. Stolz, T. Gerriets, A. Kluge, W.-P. Klovekorn, M. Kaps, and G. Bachmann Diffusion-Weighted Magnetic Resonance Imaging and Neurobiochemical Markers After Aortic Valve Replacement: Implications for Future Neuroprotective Trials? Stroke, April 1, 2004; 35(4): 888 - 892. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. P. Schmidt, A. B.L. Tort, O. B. Amaral, A. P. Schmidt, R. Walz, J. Vettorazzi-Stuckzynski, S. H. Martins-Costa, J. G. L. Ramos, D. O. Souza, and L. V.C. Portela Serum S100B in Pregnancy-Related Hypertensive Disorders: A Case-Control Study Clin. Chem., February 1, 2004; 50(2): 435 - 438. [Full Text] [PDF]
|
|
|
|
|
|
H. Kinoshita, H. Iranami, K. Fujii, A. Yamazaki, M. Shimogai, K. Nakahata, Y. Hironaka, and Y. Hatano The Use of Bone Cement Induces an Increase in Serum Astroglial S-100B Protein in Patients Undergoing Total Knee Arthroplasty Anesth. Analg., December 1, 2003; 97(6): 1657 - 1660. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Becker, D. Kindrick, R. McCarron, J. Hallenbeck, and R. Winn Adoptive Transfer of Myelin Basic Protein-Tolerized Splenocytes to Naive Animals Reduces Infarct Size: A Role for Lymphocytes in Ischemic Brain Injury? Stroke, July 1, 2003; 34(7): 1809 - 1815. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. H. Rainer, L. K.S. Wong, W. Lam, E. Yuen, N. Y.L. Lam, C. Metreweli, and Y.M. D. Lo Prognostic Use of Circulating Plasma Nucleic Acid Concentrations in Patients with Acute Stroke Clin. Chem., April 1, 2003; 49(4): 562 - 569. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-H. Oh, J.-G. Lee, S.-J. Na, J.-H. Park, Y.-C. Choi, and W.-J. Kim Prediction of Early Clinical Severity and Extent of Neuronal Damage in Anterior-Circulation Infarction Using the Initial Serum Neuron-Specific Enolase Level Arch Neurol, January 1, 2003; 60(1): 37 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Michetti and D. Gazzolo S100B Protein in Biological Fluids: A Tool for Perinatal Medicine Clin. Chem., December 1, 2002; 48(12): 2097 - 2104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-W. Elting, G. A. Sulter, M. Kaste, K. R. Lees, H. C. Diener, M. Hommel, M. Versavel, A. W. Teelken, and J. De Keyser AMPA Antagonist ZK200775 in Patients With Acute Ischemic Stroke: Possible Glial Cell Toxicity Detected by Monitoring of S-100B Serum Levels Stroke, December 1, 2002; 33(12): 2813 - 2818. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M. Bokesch, E. Appachi, M. Cavaglia, E. Mossad, and R. B.B. Mee A Glial-Derived Protein, S100B, in Neonates and Infants with Congenital Heart Disease: Evidence for Preexisting Neurologic Injury Anesth. Analg., October 1, 2002; 95(4): 889 - 892. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Petzold, M. J. Eikelenboom, D. Gveric, G. Keir, M. Chapman, R. H. C. Lazeron, M. L. Cuzner, C. H. Polman, B. M. J. Uitdehaag, E. J. Thompson, et al. Markers for different glial cell responses in multiple sclerosis: clinical and pathological correlations Brain, July 1, 2002; 125(7): 1462 - 1473. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. V.C. Portela, A. B.L. Tort, D. V. Schaf, L. Ribeiro, D. B. Nora, R. Walz, L. N. Rotta, C. T. Silva, J. V. Busnello, F. Kapczinski, et al. The Serum S100B Concentration Is Age Dependent Clin. Chem., June 1, 2002; 48(6): 950 - 952. [Full Text] [PDF]
|
|
|
|
 |
|
 L. V. C. Portela, J. C. T. Brenol, R. Walz, M. Bianchin, A. B. L. Tort, U. P. Canabarro, S. Beheregaray, J. A. Marasca, R. M. Xavier, E. C. Neto, et al. Serum S100B Levels in Patients with Lupus Erythematosus: Preliminary Observation Clin. Vaccine Immunol., January 1, 2002; 9(1): 164 - 166. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Gartner, W. Lang, F. Leutmetzer, H. Domanovits, W. Waldhausl, and L. Wagner Cerebral Expression and Serum Detectability of Secretagogin, a Recently Cloned EF-hand Ca2+ -binding Protein Cereb Cortex, December 1, 2001; 11(12): 1161 - 1169. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. W. Suttner, S. N. Piper, K. Lang, I. Huttner, B. Kumle, and J. Boldt Cerebral effects and blood sparing efficiency of sodium nitroprusside-induced hypotension alone and in combination with acute normovolaemic haemodilution Br. J. Anaesth., November 1, 2001; 87(5): 699 - 705. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Hara, G. Mies, R. Hata, and K.-A. Hossmann Gene Expressions After Thrombolytic Treatment of Middle Cerebral Artery Clot Embolism in Mice Stroke, August 1, 2001; 32(8): 1912 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. W. Bottiger, S. Mobes, R. Glatzer, H. Bauer, A. Gries, P. Bartsch, J. Motsch, and E. Martin Astroglial Protein S-100 Is an Early and Sensitive Marker of Hypoxic Brain Damage and Outcome After Cardiac Arrest in Humans Circulation, June 5, 2001; 103(22): 2694 - 2698. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Herrmann, P. Vos, M. T. Wunderlich, C. H. M. M. de Bruijn, and K. J. B. Lamers Release of Glial Tissue-Specific Proteins After Acute Stroke : A Comparative Analysis of Serum Concentrations of Protein S-100B and Glial Fibrillary Acidic Protein Stroke, November 1, 2000; 31(11): 2670 - 2677. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Herrmann, A. D. Ebert, I. Galazky, M. T. Wunderlich, W. S. Kunz, and C. Huth Neurobehavioral Outcome Prediction After Cardiac Surgery : Role of Neurobiochemical Markers of Damage to Neuronal and Glial Brain Tissue Stroke, March 1, 2000; 31(3): 645 - 650. [Abstract] [Full Text] [PDF]
|
|