The Phosphorylated Neurofilament-H: A Prognostic Marker in Ischaemic Stroke

Abstract Background: Stroke is the most common life-threatening neurological disease worldwide which affects about 15 million people yearly. The current study intended to evaluate the possible role of the phosphorylated neurofilament-H (PNF-H) level in predicting the functional outcome in patients with acute ischaemic cerebrovascular disease. Materials and Methods: The study was carried out on 50 adult patients with acute ischaemic cerebrovascular disease. A group of 20 healthy volunteers were used as a control. All patients underwent, on admission, a computed tomography (CT) scan of the brain, routine laboratory investigations, and magnetic resonance imaging (MRI) if indicated. The patients were then followed for three months and assessed by the PNF-H levels, the Glasgow Coma Scale (GCS), and the National Institute of Health Stroke Scale (NIHSS) on day one and day seven. The outcome was assessed by the Glasgow Outcome Score and Modified Rankin Score (MRS) after three months. Patients were classified according to MRS into two groups: group I with a good outcome (MRS = 1, 2, 3) and group II with a poor outcome (MRS = 4, 5, 6). Results: On day seven, the mean PNF-H concentrations were significantly elevated in group I and group II as compared to day one or controls ( P < 0.001). In addition, group II showed significantly lower PNF-H levels on day seven as compared to group I. The results obtained from the receiver operating characteristic curve performed for the outcome of ischaemic stroke show that PNF-H at a cutoff of 8.1 ng/mL could predict the outcome after acute ischaemic stroke. Conclusion: Our results demonstrate the advantage of using PNF-H as an early prognostic marker for the outcome in patients with acute ischaemic stroke.