Neurochemical Research

, 36:2287 | Cite as

Hyperacute Detection of Neurofilament Heavy Chain in Serum Following Stroke: A Transient Sign

  • Johann Sellner
  • Amit Patel
  • Pooja Dassan
  • Martin M. Brown
  • Axel Petzold
Original Paper


Serological biomarkers which enable quick and reliable diagnosis or measurement of the extent of irreversible brain injury early in the course of stroke are eagerly awaited. Neurofilaments (Nf) are a group of proteins integrated into the scaffolding of the neuronal and axonal cytoskeleton and an established biomarker of neuro-axonal damage. The Nf heavy chain (NfHSMI35) was assessed together with brain-specific astroglial proteins GFAP and S100B in hyperacute stroke (6 and 24 h from symptom onset) and daily for up to 6 days. Twenty-two patients with suspected stroke (median NIHSS 8) were recruited in a prospective observational study. Evidence for an ischaemic or haemorrhagic lesion on neuroimaging was found in 18 (ischaemia n = 16, intracerebral haemorrhage n = 2). Serum NfHSMI35 levels became detectable within 24 h post-stroke (P < 0.0001) and elevated levels persisted over the study course. While GFAP was not detectable during the entire course, S100B levels peaked at the end of the observation period. The data indicate that significant in vivo information on the pathophysiology of stroke may be obtained by the determination of NfHSMI35. Further studies are required to evaluate whether NfHSMI35 in hyperacute stroke reflects the extent of focal ischaemic injury seen on neuroimaging or is a consequence of more diffuse neuro-axonal damage.


Neurofilament Biomarker Ischaemic stroke Blood–brain barrier Pathophysiology 



JS is supported by a scientific fellowship and a Department to Department fellowship, both from the European Federation of Neurological Sciences (EFNS). This work was supported by a grant from The Stroke Association and was undertaken at UCLH/UCL who received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme. MMB’s Chair in Stroke Medicine at University College London is supported by the Reta Lila Weston Trust for Medical Research. The authors would like to thank Prof. Geoffrey Keir for continuous support.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Johann Sellner
    • 1
    • 2
  • Amit Patel
    • 3
  • Pooja Dassan
    • 4
  • Martin M. Brown
    • 4
  • Axel Petzold
    • 3
    • 5
  1. 1.Department of NeurologyKlinikum rechts der Isar, Technische Universität MünchenMunichGermany
  2. 2.Department of NeurologyChristian-Doppler-Klinik, Paracelsus Medizinische UniversitätSalzburgAustria
  3. 3.Department of NeuroinflammationThe National Hospital for Neurology and NeurosurgeryQueen Square, LondonUK
  4. 4.Department of Brain Repair and RehabilitationUCL Institute of NeurologyQueen Square, LondonUK
  5. 5.Department of NeurologyVU Medical CentreAmsterdamThe Netherlands

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