Neuron-specific enolase at admission as a predictor for stroke volume, severity and outcome in ischemic stroke patients: a prognostic biomarker review

• Published in: Scientific reports Vol. 14; no. 1; p. 2688
• Main Authors: Mochetti, Matheus Menão, Silva, Estêvão Garcia Porello, Correa, Adriana Aparecida Feltrin, Cabette, Marcela Rocha, Perissinotti, Iago Navas, E Silva, Lucas Oliveira Junqueira, Pessoa, Adriano de Souza, de Oliveira, Rodrigo Cardoso, da Silva, Luiz Fernando Ferraz, de Souza, Heraldo Possolo, de Alencar, Júlio César Garcia
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-02-2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308/53/2422; 692/617/375/1370/534; Biomarkers; Brain injury; Cerebral infarction; Emergency medical care; Emergency medical services; Humanities and Social Sciences; Ischemia; Literature reviews; Mortality; multidisciplinary; Neuroimaging; Observational studies; Phosphopyruvate hydratase; Science; Science (multidisciplinary); Stroke
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-53080-6

An ideal blood biomarker for stroke should provide reliable results, enable fast diagnosis, and be readily accessible for practical use. Neuron-specific enolase (NSE), an enzyme released after neuronal damage, has been studied as a marker for brain injury, including cerebral infarction. However, different methodologies and limited sample sizes have restricted the applicability of any potential findings. This work aims to determine whether NSE levels at Emergency Department (ED) admission correlate with stroke severity, infarcted brain volume, functional outcome, and/or death rates. A systematic literature review was performed using PubMed, Embase, and Scopus databases. Each reviewer independently assessed all published studies identified as potentially relevant. All relevant original observational studies (cohort, case–control, and cross-sectional studies) were included. Eleven studies (1398 patients) met the inclusion criteria. Among these, six studies reported a significant correlation between NSE levels and stroke severity, while only one found no association. Four studies indicated a positive relationship between infarcted brain volume assessed by imaging and NSE levels, in contrast to the findings of only one study. Four studies identified an association related to functional outcome and death rates, while three others did not reach statistical significance in their findings. These data highlight that NSE levels at ED admissions proved to be a promising tool for predicting the outcome of ischemic stroke patients in most studies. However, they presented high discrepancies and low robustness. Therefore, further research is necessary to establish and define the role of NSE in clinical practice.