Secondary neurodegeneration following Stroke: what can blood biomarkers tell us?

Autor: Brunelli S; NeuroRehabilitation Unit 4, IRCCS Santa Lucia Foundation, Rome, Italy., Giannella E; Clinical Neurochemistry Unit and Biobank, IRCCS Santa Lucia Foundation, Rome, Italy., Bizzaglia M; Radiology and Diagnostic Imaging Unit, IRCCS Santa Lucia Foundation, Rome, Italy., De Angelis D; NeuroRehabilitation Unit 4, IRCCS Santa Lucia Foundation, Rome, Italy., Sancesario GM; Clinical Neurochemistry Unit and Biobank, IRCCS Santa Lucia Foundation, Rome, Italy.
Jazyk: angličtina
Zdroj: Frontiers in neurology [Front Neurol] 2023 Sep 01; Vol. 14, pp. 1198216. Date of Electronic Publication: 2023 Sep 01 (Print Publication: 2023).
DOI: 10.3389/fneur.2023.1198216
Abstrakt: Stroke is one of the leading causes of death and the primary source of disability in adults, resulting in neuronal necrosis of ischemic areas, and in possible secondary degeneration of regions surrounding or distant to the initial damaged area. Secondary neurodegeneration (SNDG) following stroke has been shown to have different pathogenetic origins including inflammation, neurovascular response and cytotoxicity, but can be associated also to regenerative processes. Aside from focal neuronal loss, ipsilateral and contralateral effects distal to the lesion site, disruptions of global functional connectivity and a transcallosal diaschisis have been reported in the chronic stages after stroke. Furthermore, SNDG can be observed in different areas not directly connected to the primary lesion, such as thalamus, hippocampus, amygdala, substantia nigra, corpus callosum, bilateral inferior fronto-occipital fasciculus and superior longitudinal fasciculus, which can be highlighted by neuroimaging techniques. Although the clinical relevance of SNDG following stroke has not been well understood, the identification of specific biomarkers that reflect the brain response to the damage, is of paramount importance to investigate in vivo the different phases of stroke. Actually, brain-derived markers, particularly neurofilament light chain, tau protein, S100b, in post-stroke patients have yielded promising results. This review focuses on cerebral morphological modifications occurring after a stroke, on associated cellular and molecular changes and on state-of-the-art of biomarkers in acute and chronic phase. Finally, we discuss new perspectives regarding the implementation of blood-based biomarkers in clinical practice to improve the rehabilitation approaches and post stroke recovery.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Brunelli, Giannella, Bizzaglia, De Angelis and Sancesario.)
Databáze: MEDLINE