Diagnostic Value of Serum Neuron-Specific Enolase Level in Patients With Acute Ischemic Stroke; A Systematic Review and Meta-Analysis
International Clinical Neuroscience Journal,
Vol. 6 No. 2 (2019),
29 June 2019
Background: We aim to assess the predictive value of serum neuron-specific enolase (NSE) level in patients with acute ischemic stroke referring to the emergency department.
Methods: This systematic review and meta-analysis performed, considering the PRISMA and MOOSE statement guidelines. A computerized literature search of the known medical database conducted by using the relevant keywords. We included studies published before November 2016 in which stroke patients compared with non-stroke controls and also studies evaluating the serum levels of NSE in the study groups. Statistical analysis was pooled in a random effect model analysis using the Comprehensive Meta-Analysis software.
Results: We included 12 articles in the qualitative and quantitative analysis, that their quality acceptable based on the Newcastle Ottawa Scale (NOS scale). The pooled effect estimates showed that NSE is significantly higher in ischemic stroke patients in comparison with their controls with a high effect estimate [OR 9.68, 95% CI (3.06 to 30.6)]. The effect estimate remained statistically significant under the fixed and random effects model.
Conclusion: Our results show higher levels of NSE in patients with stroke than in the control group, indicating that NSE plays a role in the diagnosis of stroke. In terms of prognosis, there is evidence regarding the direct and indirect relationship; and it founded that serum levels of NSE is higher in larger stroke volume, which needs further research.
- Phosphopyruvate Hydratase
- Predictive value of tests
How to Cite
Ohira T, Shahar E, Chambless L, Rosamond W, Mosley Jr T, Folsom A. Risk factors for ischemic stroke subtypes: the Atherosclerosis Risk in Communities study. Stroke. 2006;37(10):2493.
Benjamin E, Blaha M, Chiuve S, Cushman M, Das S, Deo R, et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation. 2017;135(10):e146.
Baratloo A, Forouzanfar MM, Hashemi B, Safari S, Kasmaei HD, Rouhipour A, et al. Tissue plasminogen activator: A literature review. Archives of Neuroscience. 2016;3(1):e30452.
Delavar-Kasmaei H, Baratloo A, Nasiri Z, Soleymani M, Oraee-Yazdani M. Recombinant tissue plasminogen activator administration in patients with cerebrovascular accident; a case series. Archives of Neuroscience. 2015;2(2):e23315.
Kidwell C. MRI biomarkers in acute ischemic stroke: a conceptual framework and historical analysis. Stroke. 2013;44(2):570.
Leigh R, Krakauer JW. MRI-Guided Selection of Patients for Acute Ischemic Stroke Treatment. Current opinion in neurology. 2014;27(4):425.
Amans MR, Cooke DL, Vella M, Dowd CF, Halbach VV, Higashida RT, et al. Contrast Staining on CT after DSA in Ischemic Stroke Patients Progresses to Infarction and Rarely Hemorrhages. Interventional Neuroradiology. 2014;20(1):106.
Mitomi M, Kimura K, Aoki J, Iguchi Y. Comparison of CT and DWI findings in ischemic stroke patients within 3 hours of onset. Journal of Stroke and Cerebrovascular Diseases. 2014;23(1):37-42.
Baratloo A, Rahimpour L, Abushouk AI, Safari S, Lee CW, Abdalvand A. Effects of Telestroke on Thrombolysis Times and Outcomes: A Meta-analysis. Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors. 2018;22(4):472-84.
Haque A, Ray SK, Cox A, Banik NL. Neuron specific enolase: a promising therapeutic target in acute spinal cord injury. Metabolic brain disease. 2016;31(3):487.
Kansal K, Irwin DJ. The use of cerebrospinal fluid and neuropathological studies in neuropsychiatry practice and research. The Psychiatric clinics of North America. 2015;38(2):309.
Bharosay A, Bharosay VV, Varma M, Saxena K, Sodani A, Saxena R. Correlation of Brain Biomarker Neuron Specific Enolase (NSE) with Degree of Disability and Neurological Worsening in Cerebrovascular Stroke. Indian Journal of Clinical Biochemistry. 2012;27(2):186.
Zaheer S, Beg M, Rizvi I, Islam N, Ullah E, Akhtar N. Correlation between serum neuron specific enolase and functional neurological outcome in patients of acute ischemic stroke. Annals of Indian Academy of Neurology. 2013;16(4):504.
Pandey A, Shrivastava A, Saxena K. Neuron specific enolase and c-reactive protein levels in stroke and its subtypes: correlation with degree of disability. Neurochemical research. 2014;39(8):1426.
Anand N, Stead L. Neuron-specific enolase as a marker for acute ischemic stroke: a systematic review. Cerebrovascular diseases (Basel, Switzerland). 2005;20(4):213.
Singh H, Pandey A, Shrivastava A, Raizada A, Singh S, Singh N. Prognostic value of neuron specific enolase and IL-10 in ischemic stroke and its correlation with degree of neurological deficit. Clinica chimica acta; international journal of clinical chemistry. 2013;419:136.
Lu K, Xu X, Cui S, Wang F, Zhang B, Zhao Y. Serum neuron specific enolase level as a predictor of prognosis in acute ischemic stroke patients after intravenous thrombolysis. Journal of the neurological sciences. 2015;359(1-2):202.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS medicine. 2009;6(7):e1000097.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Jama. 2000;283(15):2008-12.
Borenstein M, Hedges L. V., Higgins, JPT, & Rothstein, HR (2009). Introduction to Meta-Analysis. John Wiley and &Sons, Inc. UK.
Deeks JJ, Higgins J, Altman DG. Analysing data and undertaking meta‐analyses. Cochrane handbook for systematic reviews of interventions: Cochrane book series. 2008:243-96.
Hill MD, Jackowski G, Bayer N, Lawrence M, Jaeschke R. Biochemical markers in acute ischemic stroke. Canadian Medical Association Journal. 2000;162(8):1139-40.
Oh SH, Lee JG, Na SJ, Park JH, Kim WJ. The effect of initial serum neuron-specific enolase level on clinical outcome in acute carotid artery territory infarction. Yonsei Medical Journal. 2002;43(3):357-62.
Oh S-H, Lee J-G, Na S-J, Park J-H, Choi Y-C, Kim W-J. Prediction of early clinical severity and extent of neuronal damage in anterior-circulation infarction using the initial serum neuron-specific enolase level. Archives of neurology. 2003;60(1):37-41.
Bharosay A, Bharosay VV, Varma M, Saxena K, Sodani A, Saxena R. Correlation of brain biomarker neuron specific enolase (NSE) with degree of disability and neurological worsening in cerebrovascular stroke. Indian Journal of Clinical Biochemistry. 2012;27(2):186-90.
Kaca-Oryńska M, Tomasiuk R, Friedman A. Neuron-specific enolase and S 100B protein as predictors of outcome in ischaemic stroke. Neurologia i neurochirurgia polska. 2010;44(5):459-63.
González-García S, González-Quevedo A, Fernández-Concepción O, Peña-Sánchez M, Menéndez-Saínz C, Hernández-Díaz Z, et al. Short-term prognostic value of serum neuron specific enolase and S100B in acute stroke patients. Clinical biochemistry. 2012;45(16-17):1302-7.
Brea D, Sobrino T, Blanco M, Cristobo I, Rodríguez-González R, Rodríguez-Yañez M, et al. Temporal profile and clinical significance of serum neuron-specific enolase and S100 in ischemic and hemorrhagic stroke. Clinical chemistry and laboratory medicine. 2009;47(12):1513.
Butterworth R, Wassif W, Sherwood R, Gerges A, Poyser K, Garthwaite J, et al. Serum neuron-specific enolase, carnosinase, and their ratio in acute stroke: An enzymatic test for predicting outcome? Stroke. 1996;27(11):2064-8.
Missler U, Wiesmann M, Friedrich C, Kaps M. S-100 protein and neuron-specific enolase concentrations in blood as indicators of infarction volume and prognosis in acute ischemic stroke. Stroke. 1997;28(10):1956-60.
Cunningham R, Young I, Winder J, O'kane M, McKinstry S, Johnston C, et al. Serum neurone specific enolase (NSE) levels as an indicator of neuronal damage in patients with cerebral infarction. European journal of clinical investigation. 1991;21(5):497-500.
Wunderlich MT, Lins H, Skalej M, Wallesch C-W, Goertler M. Neuron-specific enolase and tau protein as neurobiochemical markers of neuronal damage are related to early clinical course and long-term outcome in acute ischemic stroke. Clinical neurology and neurosurgery. 2006;108(6):558-63.
Ahmad O, Wardlaw J, Whiteley WN. Correlation of levels of neuronal and glial markers with radiological measures of infarct volume in ischaemic stroke: a systematic review. Cerebrovascular Diseases. 2012;33(1):47-54.
Park S-Y, Kim J, Kim O-J, Kim J-K, Song J, Shin D-A, et al. Predictive value of circulating interleukin-6 and heart-type fatty acid binding protein for three months clinical outcome in acute cerebral infarction: multiple blood markers profiling study. Critical Care. 2013;17(2):R45.
Kaca-Oryńska M, Tomasiuk R, Friedman A. Neuron-specific enolase and S 100B protein as predictors of outcome in ischaemic stroke. Neurologia i neurochirurgia polska. 2010;44(5):459.
Shahrokhi N, Soltani Z, Khaksari M, Karamouzian S, Mofid B, Asadikaram G. The serum changes of neuron-specific enolase and intercellular adhesion molecule-1 in patients with diffuse axonal injury following progesterone administration: a randomized clinical trial. Archives of trauma research. 2016;5(3).
Andersen KK, Olsen TS, Dehlendorff C, Kammersgaard LP. Hemorrhagic and ischemic strokes compared: stroke severity, mortality, and risk factors. Stroke. 2009;40(6):2068-72.
- Abstract Viewed: 362 times
- PDF Downloaded: 302 times