A team of researchers has discovered that a protein found in the nervous system can predict the severity of brain damage and long-term outcomes in patients who have suffered a stroke. Their analysis of data from 464 patients who experienced different types of strokes may provide clinicians with a reliable marker to assess damage to brain tissue, which could facilitate rehabilitation strategies and streamline the testing of new therapeutics in trials. Strokes are a major cause of death and disability worldwide, but patients can show a wide range of outcomes: some have only temporary and mild symptoms while others die or develop permanent disabilities. Current clinical scoring systems such as the National Institutes of Health Stroke Scale correlate poorly with the actual extent of tissue and neuron damage in patients, which has hampered clinicians’ ability to predict outcomes and tailor treatment protocols. However, Tania Gendron and colleagues discovered that the levels of neurofilament light protein (NFL) in blood consistently correlated with more severe brain damage and poorer survival rates after stroke, according to data from 314 patients with three different types of stroke. The researchers confirmed this link using plasma samples from two additional groups of patients with stroke (150 total) and 48 healthy controls; they also showed that patients with lower NFL levels recovered day-to-day function better 6 months after stroke. Gendron et al. say one key step to clinical translation will be to determine exactly when blood NFL levels begin to correlate with long-term outcomes in the aftermath of stroke.

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