Transient increase in CSF GAP-43 concentration after ischemic stroke |
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Authors: | Åsa Sandelius Nicholas C Cullen Åsa Källén Lars Rosengren Crister Jensen Vesna Kostanjevecki Manu Vandijck Henrik Zetterberg |
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Institution: | 1.Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry,The Sahlgrenska Academy at the University of Gothenburg,M?lndal,Sweden;2.Department of Neurology, Perelman School of Medicine,University of Pennsylvania,Philadelphia,USA;3.Clinical Neurochemistry Laboratory,Sahlgrenska University Hospital,M?lndal,Sweden;4.Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation,The Sahlgrenska Academy at University of Gothenburg,Gothenburg,Sweden;5.Institute of Clinical Sciences,University of Gothenburg,Gothenburg,Sweden;6.Fujirebio Europe nv,Ghent,Belgium;7.UK Dementia Research Institute,London,UK;8.Department of Neurodegenerative Disease,UCL Institute of Neurology,London,UK;9.Department of Psychiatry and Neurochemistry,Sahlgrenska University Hospital/M?lndal,M?lndal,Sweden |
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Abstract: | BackgroundCerebrospinal fluid (CSF) biomarkers reflect ongoing processes in the brain. Growth-associated protein 43 (GAP-43) is highly upregulated in brain tissue shortly after experimental ischemia suggesting the CSF GAP-43 concentration may be altered in ischemic brain disorders. CSF GAP-43 concentration is elevated in Alzheimer’s disease patients; however, patients suffering from stroke have not been studied previously.MethodsThe concentration of GAP-43 was measured in longitudinal CSF samples from 28 stroke patients prospectively collected on days 0–1, 2–4, 7–9, 3?weeks, and 3–5?months after ischemia and cross-sectionally in 19 controls. The stroke patients were clinically evaluated using a stroke severity score system. The extent of the brain lesion, including injury size and degrees of white matter lesions and atrophy were evaluated by CT and magnetic resonance imaging.ResultsIncreased GAP-43 concentration was detected from day 7–9 to 3?weeks after stroke, compared to day 1–4 and to levels in the control group (P?=?0.02 and P?=?0.007). At 3–5?months after stroke GAP-43 returned to admission levels. The initial increase in GAP-43 during the nine first days was associated to stroke severity, the degree of white matter lesions and atrophy and correlated positively with infarct size (rs?=?0.65, P?=?0.001).ConclusionsThe transient increase of CSF GAP-43 is important to take into account when used as a biomarker for other neurodegenerative diseases such as Alzheimer’s disease. Furthermore, GAP-43 may be a marker of neuronal responses after stroke and additional studies confirming the potential of CSF GAP-43 to reflect severity and outcome of stroke in larger cohorts are warranted. |
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